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D. O'leary - One of the best experts on this subject based on the ideXlab platform.
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P-831 - The satisfaction of service users about the work and services provided by south cherwell CMHT (julier centre) feb 2011
European Psychiatry, 2012Co-Authors: H. Al-taiar, D. O'learyAbstract:The aim of this audit was to identify the performance of the Bicester component of the North Oxfordshire Community Mental health team across a selected number of patient satisfaction questions that are related to patient awareness of CPA. Methodology : The domain for audit included the following items: 1. Knowledge of the Care Coordinator 2. Accessibility of the Care Coordinator 3. Provision of a written Care plan in the last year 4. CPA meeting in the last year 5. How well does the Care Coordinator organise the Care and services 6. Whether physical health issues were covered during the regular interviews 7. Whether drug/alcohol issues were covered during interview The Care Coordinators were blinded re the service users' responses. The standard to be attained was placed at 95% positive responses by patients. In terms of staff responses, the standard was set at 100% positive responses. We have set our goal at 95%. It is clear that we have achieved our goal in three of the seven parameters covered. The results with other parameters were less than identified goal but they were higher than those obtained from the audits done by Oxford Health trust and national NHS surveys. There is a communication issue which needs signposting: that is evident by the difference between service users responses and their Care Coordinators. 1. Discussing the results with the CMHT and trying to implement it into quality plan. 2. Discussing ways on improving staff-patient communications. 3. Re-Audit after a period of time to allow time for the changes to occur.
John Thorburn - One of the best experts on this subject based on the ideXlab platform.
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Care Coordinators: A controlled evaluation of an inpatient mental health service innovation
International Journal of Mental Health Nursing, 2012Co-Authors: Malcolm W. Stewart, Karla Bergquist, Michael Wilson, John ThorburnAbstract:The study aimed to evaluate the impact of introducing designated Care Coordinators into an acute mental health inpatient unit in terms of service delivery, clinical outcomes, and service user and significant other perceptions. A pre-post-controlled design was implemented with a consecutive sample of 292 service users admitted and staying more than 5 days in two wards, with Care Coordinators introduced in one ward. Data were obtained from clinical records, standard measures, and service user and significant other surveys. Care Coordinator input was associated with significant improvements in service delivery and stronger involvement of significant others and community resources. Care-coordinated clients showed significantly better clinical outcomes, including the Health of Nations Outcome Scales behaviour subscale, less time in the intensive Care subunit, less community crisis team input in the week following discharge, and lower rates of readmission in the month following discharge. Care-coordinated service users and their significant others gave higher ratings of service delivery, outcome, and satisfaction. The results indicate that designated Care Coordinators significantly improve Care processes, outcomes, and service user experience in acute inpatient mental health settings.
Caroline Van Heugten - One of the best experts on this subject based on the ideXlab platform.
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A process evaluation of a stroke-specific follow-up Care model for stroke patients and Caregivers; a longitudinal study
BMC Nursing, 2015Co-Authors: Manon Fens, George Beusmans, Martien Limburg, Liesbeth Van Hoef, Jolanda Van Haastregt, Job Metsemakers, Caroline Van HeugtenAbstract:Background There is a need for follow-up Care after stroke, but there is no consensus about the way to organise it. An intervention providing follow-up Care for stroke patients and Caregivers showed favourable effects on the level of social activities, but no other effects were found. The intervention consists of a maximum of five home visits to patients and Caregivers during a period of 18 months post-discharge. The home visits are conducted by a stroke Care Coordinator (SCC) using a structured assessment tool. The objective of this study was to examine process-related factors that could have influenced the effectiveness of the intervention. Methods 77 stroke patients, 59 Caregivers and 4 SCCs participated in the study. Data on the organisational characteristics of and the satisfaction with the intervention were collected by means of structured assessments, interviews and self-administered questionnaires at 1, 6, 12 and 18 months of follow-up. The intervention was provided between April 2008 and June 2011. Results Patients received an average of 3.8 home visits (SD 1.4) and 55% of them had a follow-up period of a maximum of 18 months. There were 1074 problems identified and the SCCs initiated 363 follow-up Care and referral options. Stroke patients and Caregivers were very satisfied with the intervention. The SCCs were satisfied with the assessment tool, but would like to see a structured referral system. Conclusions The intervention was only partially performed in accordance with the protocol and was positively evaluated by patients, Caregivers and SCCs. It is recommended to add a structured referral system to the intervention.
Patsy Yates - One of the best experts on this subject based on the ideXlab platform.
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The Effectiveness of the Nurse Care Coordinator Role on Patient-Reported and Health Service Outcomes: A Systematic Review.
Evaluation & the health professions, 2017Co-Authors: Aaron Conway, Christopher J. O'donnell, Patsy YatesAbstract:This systematic review examined the effectiveness of nurse Care Coordinator (CC) roles on patient-reported and health service outcomes. Multiple electronic databases (Medline, CINAHL, and EMBASE) were searched and the Cochrane Risk of Bias Assessment Tool was applied by two independent reviewers. The Grades of Recommendation, Assessment, Development, and Evaluation system was used to assess the quality of evidence. A total of 45 articles (reporting on 36 studies) were included. The majority of studies (n = 28, 78%) were conducted in the United States and published after 2009 (n = 24, 67%). Thirteen studies (36%) used a randomized controlled trial design. A total of 17 studies evaluated patient-reported outcomes and 29 studies reported health service outcomes. The individual components of nurse CC roles that were evaluated ranged considerably. The impact of nurse Care coordination on patient-reported and health service outcomes was inconsistent. There was an indication from higher quality studies that nurse Care coordination roles were more likely to result in improved patient and health service outcomes where they involved frequent, in-person interactions, had ongoing follow-up with monitoring of disease status, and involved transition Care and the application of behavior change principles.
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Findings from a systematic review on cancer Care Coordinators
2013Co-Authors: Danette H. Langbecker, Patsy Yates, Rachel WhiffenAbstract:Aims - Cancer Care Coordinators have been implemented by a number of health services in an effort to overcome service fragmentation and improve patient and service outcomes, although the evidence is broad and poorly synthesised. This systematic review sought to examine the impact of these roles on patient Care and outcomes and service delivery, from the perspective of patients, Carers and clinicians. Methods - We included articles with any study design published in English between 1990 and 2012 with adult patients with at least 70% of the sample diagnosed with cancer. Care coordination studies aiming to increase cancer screening or follow-up after abnormal test results were excluded. We searched MEDLINE, EMBASE, PubMed and other databases for published and unpublished studies. Results - We included 59 studies from 72 articles involving 23,750 participants; this included 11 randomised controlled trials. Thirty-seven studies included in this review (n=9,107 patients) evaluated patient-reported outcomes, including quality of life, psychological morbidity, symptoms, concerns, self-efficacy, continuity of Care, satisfaction with Care and satisfaction with the Care Coordinator. In a qualitative synthesis, no impact on patient-reported outcomes of Care coordination was found, with the exception of satisfaction with Care, which was shown by most studies to increase with coordination, and satisfaction with the Care Coordinator, which was high among coordinated groups. Conclusions - The cumulative evidence suggests cancer Care coordination is associated with higher satisfaction with Care, although evidence for other outcomes is inconclusive. Studies included varied significantly in design, setting and cancer population, and studies used a diverse range of (frequently non-validated) measurement tools.
Jodie G. Katon - One of the best experts on this subject based on the ideXlab platform.
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Care coordination for pregnant veterans: VA's Maternity Care Coordinator Telephone Care Program.
Translational behavioral medicine, 2018Co-Authors: Kristina M. Cordasco, Judith R. Katzburg, Jodie G. Katon, Laurie C. Zephyrin, Joya G. Chrystal, Elizabeth M. YanoAbstract:Coordinating Care between Veterans Health Administration (VA) and community providers is essential for providing high-quality comprehensive maternity Care to women veterans, particularly those with chronic medical or mental health issues. We iteratively developed and assessed feasibility, as well as facilitators and barriers, of implementing the VA Maternity Care Coordinator Telephone Care Program, and identified specific health needs of pregnant women Veterans served by the program. We used three Plan-Do-Study-Act cycles. The final program consisted of materials supporting seven structured phone calls spanning initiation of pregnancy Care through six weeks postpartum. We used logs to measure veteran uptake and surveys and field notes to capture Care-Coordinator perceptions about potential program value and facilitators and barriers to implementing it. We conducted a medical record review assessing pregnant veterans' need for coordination of services for physical and mental health problems and health behaviors. Veterans' uptake was 60%. Implementation facilitators included conducting training sessions for program Coordinators and tailoring materials to address differences across VA facilities. Implementation barriers included limited information and communication technology tools to support the program and lack of Coordinator time for delivering the telephone Care. Among 244 pregnant veterans, 41% had pre-pregnancy chronic physical problem(s); 34% mental health problem(s); 18% actively or recently smoked. Implementation of a telephone-based Care coordination program for pregnant veterans was feasible. Effective program spread required tailoring for local variations in resources and processes, investing in information and communication technology tools and allocating Coordinator time to deliver Care. Pregnant women veterans have a substantial burden of physical health, mental health, and risky health behaviors needing Care coordination.
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improving perinatal mental health Care for women veterans description of a quality improvement program
Maternal and Child Health Journal, 2017Co-Authors: Jodie G. Katon, Lacey Lewis, Selma Hercinovic, Amanda Mcnab, John C Fortney, Susan RoseAbstract:Purpose We describe results from a quality improvement project undertaken to address perinatal mental healthCare for women veterans. Description This quality improvement project was conducted in a single VA healthCare system between 2012 and 2015 and included screening for depressive symptoms with the Edinburgh Postnatal Depression Scale (EPDS) three times during the perinatal period, a dedicated maternity Care Coordinator (MCC), an on-site clinical social worker, and an on-site obstetrician/gynecologist (Ob/gyn). Information on prior mental health diagnosis was collected by the MCC or Ob/gyn. The prevalence of perinatal depressive symptoms and receipt of mental healthCare among those with such symptoms are reported by presence of a pre-pregnancy mental health diagnosis. Assessment Of the 199 women who used VA maternity benefits between 2012 and 2015, 56% (n = 111) had at least one pre-pregnancy mental health diagnosis. Compared to those without a pre-pregnancy mental health diagnosis, those with such a diagnosis were more likely to be screened for perinatal depressive symptoms at least once (61.5% vs. 46.8%, p = 0.04). Prevalence of depressive symptoms was 46.7% among those with a pre-pregnancy mental health diagnosis and 19.2% among those without. Among those with a pre-pregnancy mental health diagnosis and depressive symptoms (n = 35), 88% received outpatient mental healthCare and 77% met with the clinical social worker. Among those without a pre-pregnancy mental health diagnosis and depressive symptoms (n = 8), none received outpatient mental healthCare, but 77.8% met with the clinical social worker. Conclusion Improving perinatal mental healthCare for women veterans requires a multidisciplinary approach, including on-site integrated mental healthCare.