The Experts below are selected from a list of 246 Experts worldwide ranked by ideXlab platform
Linda H. Aiken - One of the best experts on this subject based on the ideXlab platform.
-
Home Health Agency work environments and hospitalizations.
Medical care, 2014Co-Authors: Olga F. Jarrín, Linda Flynn, Eileen T. Lake, Linda H. AikenAbstract:Background: An important goal of Home Health care is to assist patients to remain in community living arrangements. Yet Home care often fails to prevent hospitalizations and to facilitate discharges to community living, thus putting patients at risk of additional Health challenges and increasing care costs. Objectives: To determine the relationship between Home Health Agency work environments and Agency-level rates of acute hospitalization and discharges to community living. Methods and Design: Analysis of linked Center for Medicare and Medicaid Services Home Health Compare data and nurse survey data from 118 Home Health agencies. Robust regression models were used to estimate the effect of work environment ratings on between-Agency variation in rates of acute hospitalization and community discharge.
Olga F. Jarrín - One of the best experts on this subject based on the ideXlab platform.
-
Home Health Agency work environments and hospitalizations.
Medical care, 2014Co-Authors: Olga F. Jarrín, Linda Flynn, Eileen T. Lake, Linda H. AikenAbstract:Background: An important goal of Home Health care is to assist patients to remain in community living arrangements. Yet Home care often fails to prevent hospitalizations and to facilitate discharges to community living, thus putting patients at risk of additional Health challenges and increasing care costs. Objectives: To determine the relationship between Home Health Agency work environments and Agency-level rates of acute hospitalization and discharges to community living. Methods and Design: Analysis of linked Center for Medicare and Medicaid Services Home Health Compare data and nurse survey data from 118 Home Health agencies. Robust regression models were used to estimate the effect of work environment ratings on between-Agency variation in rates of acute hospitalization and community discharge.
Richard H. Fortinsky - One of the best experts on this subject based on the ideXlab platform.
-
Interrater Reliability of the Outcomes and Assessment Information Set: Results From the Field
Gerontologist, 2004Co-Authors: Elizabeth A. Madigan, Richard H. FortinskyAbstract:: The Outcomes and Assessment Information Set (OASIS) is now used extensively for regulatory, reimbursement, research, and clinical purposes in Home Health care. However, little is known about the interrater reliability of OASIS items based on assessments from Home-Health-Agency clinicians. Therefore, we evaluated OASIS item interrater reliability among 88 patients from 21 agencies. Of 25 items studied, all except 2 had weighted kappa values of kappa > or = 0.60. We conclude that OASIS item interrater reliability was highly adequate in this study, but we recommend routine interrater-reliability evaluation by agencies to maximize the quality of OASIS data nationally.
-
fall risk assessment and management in clinical practice views from Healthcare providers
Journal of the American Geriatrics Society, 2004Co-Authors: Richard H. Fortinsky, Michele Iannuzzisucich, Dorothy I Baker, Margaret Gottschalk, Mary B King, Cynthia J Brown, Mary E TinettiAbstract:Objectives: To determine the extent to which Healthcare providers reportedly address evidence-based fall risk factors in older patients after exposure to an educational intervention and to determine barriers reportedly encountered when these Healthcare providers intervene with or refer older patients with identified fall-risk factors. Design: Cross-sectional study using a structured interview. Setting: Geographic area of Connecticut where the Connecticut Collaboration for Fall Prevention (CCFP) has been implemented. Participants: Emergency department (ED) physicians, hospital-based discharge planners or care coordinators (nurses or social workers), Home Health Agency nurses, and office-based primary care physicians (total n=33) after exposure to the CCFP implementation team. Measurements: Self-reported practices (direct intervention or referral) and barriers when addressing seven evidence-based risk factors for falls: gait and transfer impairments, balance disturbances, multiple medications, postural hypotension, sensory and perceptive deficits, foot and footwear problems, and environmental hazards. Results: Respondents were most likely to report directly intervening with or referring older patients for gait and transfer impairments (85%) and balance disturbances (82%) and least likely to do so when encountering foot or footwear problems (58%) and sensory or perceptive deficits (61%). ED physicians reported lowest rates of direct intervention or referral for foot or footwear problems (20%), Home Health Agency nurses for sensory or perceptive deficits (50%), and office-based primary care physicians for foot or footwear problems (50%). Patient compliance was the most commonly reported barrier to successful direct intervention across several risk factors, whereas inadequate availability of other Healthcare providers and lack of Medicare reimbursement were the most commonly reported barriers to successful patient referrals. Conclusion: After exposure to the CCFP implementation team, the majority of Healthcare providers reported directly intervening or referring patients when addressing all risk factors, but results pinpointed specific Healthcare provider groups with room for improvement in assessment and management of specific risk factors. Patient education appears to be a necessary adjunct to Healthcare provider training, because patient compliance was a reported barrier to optimal intervention by Healthcare providers.
Adam Simning - One of the best experts on this subject based on the ideXlab platform.
-
CAPABLE Transitions: A Home Health Agency-Based Intervention to Optimize the SNF-to-Home Transition
Innovation in Aging, 2020Co-Authors: Rachel Missell, Thomas V. Caprio, Sarah L. Szanton, Kobi T Nathan, Adam SimningAbstract:Abstract Community Aging in Place-Advancing Better Living for Elders (CAPABLE) consists of an interprofessional team of a registered nurse (RN), occupational therapist (OT), and handyworker that delivers an in-Home client-specific package of interventions to optimize function. CAPABLE aims to reduce functional impairment, Home hazards, and acute medical services use and is being widely disseminated. To expand CAPABLE to older adults transitioning from the skilled nursing facility (SNF) to Home, we developed CAPABLE Transitions, which makes several important modifications to CAPABLE. First, CAPABLE Transitions will be implemented within a Medicare-certified Home Health Agency (CHHA) and delivered to CHHA clients. Second, it will be delivered to CHHA clients with and without dementia. Adding urgency to CAPABLE Transitions’ development, including persons with dementia has the potential to decrease high utilization of services and meet care transition needs. Third, it includes an initial RN care transition visit. Fourth, its services are more intensely delivered at the beginning of the intervention, shortly after SNF discharge. Beginning in the fall of 2020, CAPABLE Transitions will be tested in a feasibility study of 60 older adults discharged from post-acute SNF care to CHHA services in Rochester, NY. We have designed this 3-year feasibility study to consist of yearly recruitment waves that will enable us to iteratively assess and refine the intervention. Following this study, we hope to test CAPABLE Transitions’ effect on improving Home time, quality of life, and the use of acute medical services in order to assist older adults in aging in place.
-
Skilled Nursing Facility Patients Discharged to Home Health Agency Services Spend More Days at Home.
Journal of the American Geriatrics Society, 2020Co-Authors: Adam Simning, Jessica Orth, Jinjiao Wang, Thomas V. Caprio, Helena Temkin-greenerAbstract:OBJECTIVES To investigate the association of the utilization of Medicare-certified Home Health Agency (CHHA) services with post-acute skilled nursing facility (SNF) discharge outcomes that included Home time, rehospitalization, SNF readmission, and mortality. DESIGN Retrospective cohort study. SETTING New York State fee-for-service Medicare beneficiaries aged 65 years and older admitted to SNFs for post-acute care and discharged to the community in 2014. PARTICIPANTS A total of 25,357 older adults. MEASUREMENTS The outcomes included days spent alive in the community ("Home time"), rehospitalization, SNF readmission, and mortality within 30- and 90-day post-SNF discharge periods. The primary independent variables were SNF five-star overall quality rating and receipt of CHHA services within 7 days of SNF discharge. Zero-inflated negative binomial regression and logistic regression models characterized the association of CHHA linkage with Home time and other outcomes, respectively. RESULTS Following SNF discharge, 17,657 (69.6%) patients received CHHA services. In analyses that adjusted for patient-, market-, and other SNF-level factors, older adults discharged from higher quality SNFs were more likely to receive CHHA services. In analyses that adjusted for patient- and market-level factors, receipt of post-SNF CHHA services was associated with 2.03 and 4.17 (P
-
skilled nursing facility patients discharged to Home Health Agency services spend more days at Home
Journal of the American Geriatrics Society, 2020Co-Authors: Adam Simning, Jessica Orth, Jinjiao Wang, Thomas V. Caprio, Helena TemkingreenerAbstract:OBJECTIVES To investigate the association of the utilization of Medicare-certified Home Health Agency (CHHA) services with post-acute skilled nursing facility (SNF) discharge outcomes that included Home time, rehospitalization, SNF readmission, and mortality. DESIGN Retrospective cohort study. SETTING New York State fee-for-service Medicare beneficiaries aged 65 years and older admitted to SNFs for post-acute care and discharged to the community in 2014. PARTICIPANTS A total of 25,357 older adults. MEASUREMENTS The outcomes included days spent alive in the community ("Home time"), rehospitalization, SNF readmission, and mortality within 30- and 90-day post-SNF discharge periods. The primary independent variables were SNF five-star overall quality rating and receipt of CHHA services within 7 days of SNF discharge. Zero-inflated negative binomial regression and logistic regression models characterized the association of CHHA linkage with Home time and other outcomes, respectively. RESULTS Following SNF discharge, 17,657 (69.6%) patients received CHHA services. In analyses that adjusted for patient-, market-, and other SNF-level factors, older adults discharged from higher quality SNFs were more likely to receive CHHA services. In analyses that adjusted for patient- and market-level factors, receipt of post-SNF CHHA services was associated with 2.03 and 4.17 (P < .001) more days in the community over 30- and 90-day periods. Receiving CHHA services was also associated with decreased odds for rehospitalization (odds ratio [OR] = .68; P < .001; OR = .91; P = .008), SNF readmission (OR = .36; P < .001; OR = .62; P < .001), and death (OR = .34; P < .001; OR = .63; P < .001) over 30- and 90-day periods, respectively. CONCLUSION Among older adults discharged from a post-acute SNF stay, those who received CHHA services had better discharge outcomes. They were less likely to experience admissions to institutional care settings and had a lower mortality risk. Future efforts that examine how the type and intensity of CHHA services affect outcomes would build on this work. J Am Geriatr Soc 68:1573-1578, 2020.
Eileen T. Lake - One of the best experts on this subject based on the ideXlab platform.
-
Home Health Agency work environments and hospitalizations.
Medical care, 2014Co-Authors: Olga F. Jarrín, Linda Flynn, Eileen T. Lake, Linda H. AikenAbstract:Background: An important goal of Home Health care is to assist patients to remain in community living arrangements. Yet Home care often fails to prevent hospitalizations and to facilitate discharges to community living, thus putting patients at risk of additional Health challenges and increasing care costs. Objectives: To determine the relationship between Home Health Agency work environments and Agency-level rates of acute hospitalization and discharges to community living. Methods and Design: Analysis of linked Center for Medicare and Medicaid Services Home Health Compare data and nurse survey data from 118 Home Health agencies. Robust regression models were used to estimate the effect of work environment ratings on between-Agency variation in rates of acute hospitalization and community discharge.