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Search All Research Studies
Topics
- Care Coordination (1)
- (-) Caregiving (11)
- Children/Adolescents (2)
- Chronic Conditions (1)
- Dementia (1)
- Elderly (3)
- Health Information Technology (HIT) (1)
- Health Services Research (HSR) (1)
- Home Healthcare (4)
- Hospital Discharge (5)
- Hospitalization (1)
- Hospital Readmissions (1)
- Hospitals (2)
- Long-Term Care (2)
- Newborns/Infants (1)
- Patient-Centered Healthcare (1)
- Patient-Centered Outcomes Research (1)
- Patient and Family Engagement (1)
- Patient Experience (2)
- Provider (1)
- Provider: Clinician (1)
- Quality Measures (1)
- Stress (1)
- (-) Transitions of Care (11)
AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 11 of 11 Research Studies DisplayedBristol AA, Elmore CE, Weiss ME
Mixed-methods study examining family carers' perceptions of the relationship between intrahospital transitions and patient readiness for discharge.
Intrahospital transitions (IHTs) may disrupt care coordination. Family caregivers often serve as liaisons between the patient and healthcare professionals, yet caregivers are often excluded from care planning during IHTs. The aim of this sequential, explanatory mixed-methods study was to examine family caregiver’s perceptions about IHTs, patient and caregiver ratings of patient discharge readiness, and caregiver self-perception of level of preparedness for engaging in care at home. The researchers conducted a retrospective analysis of hospital inpatients from a parent study for whom patient and family caregiver Readiness for Hospital Discharge Scale (RHDS) score frequency of IHTs and patient and caregiver characteristics were available. The study found that a total of 268 patients discharged from July 2020 to April 2021 had completed the RHDS and 23 completed the semi-structured interviews. The majority of patients experienced 0-2 IHTs and reported high levels of discharge readiness. No association was found between IHTs and patients' RHDS scores in the quantitative analysis. However, caregiver’s perceptions of patient discharge readiness were negatively correlated with increased IHTs. In addition, non-spouse caregivers reported lower RHDS scores than spousal caregivers. During interviews, caregivers shared barriers experienced during IHTs and described the importance of being included in discharge care planning.
AHRQ-funded; HS026248; HS026505.
Citation: Bristol AA, Elmore CE, Weiss ME .
Mixed-methods study examining family carers' perceptions of the relationship between intrahospital transitions and patient readiness for discharge.
BMJ Qual Saf 2023 Aug; 32(8):447-56. doi: 10.1136/bmjqs-2022-015120..
Keywords: Caregiving, Hospital Discharge, Transitions of Care
Topham EW, Bristol A, Luther B
Caregiver inclusion in IDEAL discharge teaching: implications for transitions from hospital to home.
The purpose of this study was to explore perceptions of caregivers regarding their discharge preparation, focusing particular attention on whether and how they believed discharge preparation impacted post-discharge patient outcomes. Through interviews with four English-speaking caregivers, findings showed that, once home, the caregivers reported gaps in their knowledge of how to care for the patient, suggesting key gaps related to knowledge of warning signs and problems. Two of the four caregiver participants attributed a hospital readmission to post-discharge knowledge gaps. This study of caregiver experiences suggests that AHRQ’s IDEAL discharge planning strategy remains a useful and important framework for case managers to follow when providing discharge services.
AHRQ-funded; HS026248.
Citation: Topham EW, Bristol A, Luther B .
Caregiver inclusion in IDEAL discharge teaching: implications for transitions from hospital to home.
Prof Case Manag 2022 Jul-Aug;27(4):181-93. doi: 10.1097/ncm.0000000000000563..
Keywords: Hospital Discharge, Transitions of Care, Caregiving
Wang J, Ying M, Temkin-Greener H
Care-partner support and hospitalization in assisted living during transitional home health care.
This study examined the impact of care-partner support on outcomes among assisted living (AL) residents. Variation in care-partner and its impact on hospitalizations among AL residents receiving Medicare home health (HH) services was investigated. Analysis of national data from various databases was used and a total of 741,926 participants were identified with Medicare HH admissions in 2017. Care-partner support during the HH admission was measured in seven domains: activity of daily living (ADLs), instrumental activities of ADLs), medication administration, treatment, medical equipment, home safety, and transportation. Care-partner support was categorized as assistance not needed, care-partner currently providing assistance, care-partner needs additional training/support to provide assistance, and care-partner is unavailable/unlikely to provide assistance. Among the cohort, inadequate care-partner support was identified for all seven domains ranging from 13.1% for transportation to 49.8% for treatment and was unavailable for 0.9% for transportation to 11.0% for treatment. Having inadequate or unavailable care-partner support was related to increased risk of hospitalization by 8.9% for treatment to 41.3% for medication administration.
AHRQ-funded; HS026893.
Citation: Wang J, Ying M, Temkin-Greener H .
Care-partner support and hospitalization in assisted living during transitional home health care.
J Am Geriatr Soc 2021 May;69(5):1231-39. doi: 10.1111/jgs.17005..
Keywords: Elderly, Transitions of Care, Caregiving, Hospitalization, Home Healthcare, Long-Term Care
Zmora R, Statz TL, Birkeland RW
Transitioning to long-term care: family caregiver experiences of dementia, communities, and counseling.
Previous analyses of interventions targeting relationships between family caregivers of people with Alzheimer's disease and related dementias and residential long-term care (RLTC) staff showed modest associations with caregiver outcomes. This analysis aimed to better understand interpersonal and contextual factors that influence caregiver-staff relationships and identify targets for future interventions to improve these relationships.
AHRQ-funded; HS022836.
Citation: Zmora R, Statz TL, Birkeland RW .
Transitioning to long-term care: family caregiver experiences of dementia, communities, and counseling.
J Aging Health 2021 Jan;33(1-2):133-46. doi: 10.1177/0898264320963588..
Keywords: Elderly, Caregiving, Dementia, Transitions of Care, Long-Term Care, Chronic Conditions
Amar-Dolan LG, Horn MH, O'Connell B B
"This is how hard it is". family experience of hospital-to-home transition with a tracheostomy.
This study explores the experience of family caregivers of children and young adults with a tracheostomy during the transition from hospital to home care. Researchers sought to identify the specific unmet needs of families to direct future interventions. Using semi-structured interviews, they found a need for family-centered discharge processes including coordination of care and teaching focused on emergency preparedness.
AHRQ-funded; HS000063.
Citation: Amar-Dolan LG, Horn MH, O'Connell B B .
"This is how hard it is". family experience of hospital-to-home transition with a tracheostomy.
Ann Am Thorac Soc 2020 Jul;17(7):860-68. doi: 10.1513/AnnalsATS.201910-780OC..
Keywords: Transitions of Care, Home Healthcare, Caregiving, Patient Experience, Care Coordination, Hospital Discharge, Hospitals, Children/Adolescents, Patient-Centered Healthcare
Fuller TE, Pong DD, Piniella N
Interactive digital health tools to engage patients and caregivers in discharge preparation: implementation study.
This clinical trial studied implementation of a suite of EHR-integrated digital health tools to engage patients, caregivers, and clinicians in discharge preparation during hospitalization. Patients who were enrolled agreed to watch a discharge video, complete a checklist assessing discharge readiness, and request postdischarge text messaging with a physician 24 to 48 hours before their expected discharge date. Out of 752 patient admissions, from December 2017 to July 2018, 510 participated, 416 watched the video and completed the checklist, and 94 completed only the checklist. Most patients endorsed the tools, but felt that the video and checklist would be more useful closer to the actual discharge date. Clinicians participating in focus groups perceived the value for patients but felt that there were a number of limitations including low awareness and variable workflow regarding the intervention. A number of strategies were offered by the authors to address implementation barriers and promote adoption of these tools.
AHRQ-funded; HS024751.
Citation: Fuller TE, Pong DD, Piniella N .
Interactive digital health tools to engage patients and caregivers in discharge preparation: implementation study.
J Med Internet Res 2020 Apr 28;22(4):e15573. doi: 10.2196/15573..
Keywords: Health Information Technology (HIT), Patient and Family Engagement, Caregiving, Hospital Discharge, Transitions of Care, Hospitals
Chase JD, Russell D, Rice M
Caregivers' perceptions managing functional needs among older adults receiving post-acute home health care.
The researchers conducted telephone interviews to explore caregivers’ experiences managing physical functioning (PF) needs of older adults in the post-acute home health care setting. Caregivers depicted the enormity of caregiving tasks needed to manage older patients' PF needs and described their perceived roles and challenges in managing PF deficits, including a sense of isolation when they were the sole caregiver. The researchers conclude that their findings can guide nursing efforts to target caregiver training and support during the critical care transition period.
AHRQ-funded; HS022140.
Citation: Chase JD, Russell D, Rice M .
Caregivers' perceptions managing functional needs among older adults receiving post-acute home health care.
Res Gerontol Nurs 2019 Jul 1;12(4):174-83. doi: 10.3928/19404921-20190319-01..
Keywords: Caregiving, Elderly, Home Healthcare, Transitions of Care
Jones CD, Jones J, Bowles KH
Patient, caregiver, and clinician perspectives on expectations for home healthcare after discharge: a qualitative case study.
The objective of this study was to evaluate and compare expectations for skilled home health care (HHC) from the patient, caregiver, and HHC perspectives after hospital discharge. Results showed that unclear expectations occurred when the patient and/or caregiver expectations were uncertain or misaligned with the services received; in most such cases, the patient and caregiver did not have prior experience with HHC. Recommendations to improve HHC transitions included actively engaging both patients and caregivers in the hospital and HHC settings to provide education about HHC services and assess and address additional care needs.
AHRQ-funded; HS024569.
Citation: Jones CD, Jones J, Bowles KH .
Patient, caregiver, and clinician perspectives on expectations for home healthcare after discharge: a qualitative case study.
J Hosp Med 2019 Feb;14(2):90-95. doi: 10.12788/jhm.3140..
Keywords: Caregiving, Health Services Research (HSR), Home Healthcare, Patient Experience, Provider, Provider: Clinician, Transitions of Care
Desai AD, Jacob-Files EA, Lowry SJ
Development of a caregiver-reported experience measure for pediatric hospital-to-home transitions.
The objective for this study was to develop and test a caregiver-reported experience measure for pediatric hospital-to-home transitions. An eight-item caregiver-reported experience measure to evaluate hospital-to-home transition outcomes in pediatric populations demonstrated acceptable content validity and psychometric properties.
AHRQ-funded; HS024299.
Citation: Desai AD, Jacob-Files EA, Lowry SJ .
Development of a caregiver-reported experience measure for pediatric hospital-to-home transitions.
Health Serv Res 2018 Aug;53 Suppl 1:3084-106. doi: 10.1111/1475-6773.12864..
Keywords: Caregiving, Children/Adolescents, Patient-Centered Outcomes Research, Quality Measures, Transitions of Care
Garfield CF, Simon CD, Rutsohn J
Stress from the neonatal intensive care unit to home: paternal and maternal cortisol rhythms in parents of premature infants.
The purpose of the study was to examine cortisol diurnal rhythms, a physiologic marker of stress, over the transition from the critical care setting to home for fathers and mothers of very low-birth-weight infants, including how cortisol is associated with psychosocial stress and parenting sense of competence. The investigators noted that fathers may be especially susceptible to stressors during this transition.
AHRQ-funded; HS020316.
Citation: Garfield CF, Simon CD, Rutsohn J .
Stress from the neonatal intensive care unit to home: paternal and maternal cortisol rhythms in parents of premature infants.
J Perinat Neonatal Nurs 2018 Jul/Sep;32(3):257-65. doi: 10.1097/jpn.0000000000000296..
Keywords: Caregiving, Newborns/Infants, Newborns/Infants, Stress, Transitions of Care
Kansagara D, Chiovaro JC, Kagen D
So many options, where do we start? An overview of the care transitions literature.
The purpose of this paper is to summarize the health and utilization effects of transitional care interventions, and to identify common themes about intervention types, patient populations, or settings that modify these effects. The authors found evidence that enhanced discharge planning and hospital-at-home interventions reduced readmissions. They further found that transitional care interventions reduced readmission in patients with congestive heart failure and general medical populations.
AHRQ-funded; HS022981.
Citation: Kansagara D, Chiovaro JC, Kagen D .
So many options, where do we start? An overview of the care transitions literature.
J Hosp Med 2016 Mar;11(3):221-30. doi: 10.1002/jhm.2502.
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Keywords: Caregiving, Hospital Discharge, Hospital Readmissions, Transitions of Care