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Redesigning acute care for cognitively impaired older adults: Optimizing health care services.
LaMantia, Michael A; Boustani, Malaz A; Jhanji, Shola; Maina, Mungai; Nazir, Arif; Messina, Frank C; Frame, Amie; Alder, Catherine; Chodosh, Joshua.
Afiliación
  • LaMantia MA; Indiana University Center for Aging Research, Indianapolis, IN, USA; Regenstrief Institute, Inc., Indianapolis, IN, USA; Indiana University School of Medicine, Indianapolis, IN, USA malamant@iu.edu.
  • Boustani MA; Indiana University Center for Aging Research, Indianapolis, IN, USA; Regenstrief Institute, Inc., Indianapolis, IN, USA; Indiana University School of Medicine, Indianapolis, IN, USA.
  • Jhanji S; Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA.
  • Maina M; Indiana University Center for Aging Research, Indianapolis, IN, USA; Regenstrief Institute, Inc., Indianapolis, IN, USA.
  • Nazir A; Indiana University School of Medicine, Indianapolis, IN, USA.
  • Messina FC; Indiana University School of Medicine, Indianapolis, IN, USA.
  • Frame A; Indiana University Center for Aging Research, Indianapolis, IN, USA; Regenstrief Institute, Inc., Indianapolis, IN, USA.
  • Alder C; Eskenazi Health, Indianapolis, IN, USA.
  • Chodosh J; Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA; David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.
Dementia (London) ; 15(5): 913-30, 2016 Sep.
Article en En | MEDLINE | ID: mdl-25128821
PURPOSE OF THE STUDY: Cognitive impairment (CI) is one of several factors known to influence hospitalization, hospital length of stay, and rehospitalization among older adults. Redesigning care delivery systems sensitive to the influence of CI may reduce acute care utilization while improving care quality. To develop a foundation of fundamental needs for health care redesign, we conducted focus groups with inpatient and outpatient providers to identify barriers, facilitators, and suggestions for improvements in care delivery for patients with CI. DESIGN AND METHODS: Focus group sessions were conducted with providers to identify their approach to caring for cognitively impaired hospitalized adults; obstacles and facilitators to providing this care; and suggestions for improving the care process. Using a thematic analysis, two reviewers analyzed these transcripts to develop codes and themes. RESULTS: Seven themes emerged from the focus group transcripts. These were: (1) reflections on serving the cognitively impaired population; (2) descriptions of perceived barriers to care; (3) strategies that improve or facilitate caring for hospitalized older adults; (4) the importance of fostering a hospital friendly to the needs of older adults; (5) the need for educating staff, patients, and caregivers; (6) the central role of good communication; and (7) steps needed to provide more effective care. IMPLICATIONS: Providing effective acute care services to older adults with CI is an important challenge in health care reform. An understanding derived from the perspective of multiple professional disciplines is an important first step. Future research will build on this preliminary study in developing new acute care models for patients with CI.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Calidad de la Atención de Salud / Actitud del Personal de Salud / Evaluación de Necesidades / Disfunción Cognitiva Tipo de estudio: Prognostic_studies / Qualitative_research Límite: Humans Idioma: En Revista: Dementia (London) Año: 2016 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Calidad de la Atención de Salud / Actitud del Personal de Salud / Evaluación de Necesidades / Disfunción Cognitiva Tipo de estudio: Prognostic_studies / Qualitative_research Límite: Humans Idioma: En Revista: Dementia (London) Año: 2016 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido