PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Transitional Care”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 73 records · Page 4Linked to original sources
PubMed1998

A systematic review of the cost-effectiveness of noncardiac transitional care units.

OBJECTIVE: To critically appraise and summarize the studies examining the cost-effectiveness of noncardiac transitional care units (TCUs). DATA SOURCES: We conducted a computerized literature search using MEDLINE, and Current Contents from January 1, 1986 to December 31, 1995 and HealthSTAR from January 1, 1989 to December 31, 1995 with the key words intermediate care unit, respiratory care unit, and step-down unit. Bibliographies of all selected articles and review articles were examined. Personal files were also reviewed. STUDY SELECTION: (1) POPULATION: patients in a noncardiac TCU of an acute-care institution; (2) intervention: addition of a noncardiac TCU to the institution; and (3) outcomes: patient outcome-survival and associated costs. DATA EXTRACTION: The necessary data were abstracted and study validity was evaluated by two independent reviewers using a modification of previously published criteria. DATA SYNTHESIS: The studies were summarized qualitatively; upon inspection, they were too heterogeneous to allow quantitative analysis. While the studies all claimed that their TCUs were cost-effective, the economic evaluation designs were flawed to such an extent that the validity of the conclusions is suspect. CONCLUSIONS: To date, the evidence in the literature is insufficient to determine under which circumstances, if any, TCUs are a cost-effective alternative technology to the traditional institution with only ICU and general ward beds.

Humans↗
PubMed1989

Transitional care services and chronicity: oncology as a case in point.

Fragmentation in care is of primary concern to nurses and other individuals involved in the provision of health services. Currently, fragmentation is related to the changes that have occurred in health delivery systems, increased emphasis on cost containment, the appropriate and effective delivery of nursing care, and the increasing prevalence of chronicity in populations requiring health services. This paper examines the fragmentation of care that results under current health care delivery structures for individuals with the diagnosis of cancer and their families. Transitional care, which the clinical nurse specialist is prepared uniquely to implement, is discussed for its potential to impact positively the elements of care rendered to individuals and families living with the realities of cancer.

Communication↗
PubMedDate not supplied

Hospital readmission from a transitional care unit.

The purpose of this project was to characterize patients readmitted to the hospital during a stay in a transitional care unit (TCUT). Typically, readmitted patients were females, widowed, with 8 medical diagnoses, and taking 12 different medications. Readmission from the TCU occurred within 7 days as a result of a newly developed problem. Most patients did not return home after readmission from the TCU. Understanding high-risk patients' characteristics that lead to costly hospital readmission during a stay in the TCU can assist clinicians and healthcare providers to plan and implement timely and effective interventions, and help facility personnel in fiscal and resource management issues.

Aged↗
PubMed1979

[Neonatal transitional care unit (author's transl)].

Statistical analysis between a two year period with a five year interval (1972-1975) in a neonatal transitional care unit is evaluated. Number of resucitations doubled and neonatal mortality in the first seven days of life as well as in the first twenty four hours decreased significantly, being newborns under 1,000 gr. of weight and malformations the first two causes of death in both periods. Factors related to hypoxia which accounted for other 25% of deaths should be prevented. Importance of this type of units in huge maternities is emphasized considering their role in immediate neonatal care.

Asphyxia Neonatorum↗
PubMedDate not supplied

Transitional care: a critical dimension of the home healthcare quality agenda.

Focusing on the critical transitions of patients and their caregivers across healthcare settings and among providers is a promising approach to enhancing care coordination and improving quality. This article describes the research base for the transitional care of older adults and offers recommendations to advance the science, translate best practices into home healthcare settings, and improve the transitions of high-risk older adults to and from home healthcare. Home healthcare is a component of the healthcare industry uniquely positioned to improve transitional care and outcomes for the growing population of older adults with continuous complex needs.

Aged↗
PubMed2004

Congenital adrenal hyperplasia: transitional care.

Congenital adrenal hyperplasia (CAH) is a life-long disorder which poses management problems that are age- and sex-specific. The condition merits an organised, multi-disciplinary transitional care format similar to the kind that is now well established for Turner's syndrome in many centres. In the eyes of the paediatrician, achieving optimal growth is the primary target of CAH management during infancy and childhood. Fixation on this objective can be to the detriment of the patient because it may result in failure to appreciate the significance of metabolic disturbances that occur in later childhood, particularly in females, and which may be the progenitor of chronic problems with obesity, insulin resistance and infertility in adult life. Similarly, the care of the adult patient with CAH comprises more than just prescribing steroid replacement for primary adrenal insufficiency. The transition period between childhood and adulthood is an opportune time for review of the various management options and to assess the efficacy of steroid replacement, to consider alternative novel treatment modalities and to apply a checklist to the multi-faceted aspects of the medical, surgical and psychological needs of the patient.

Adolescent↗
PubMed2004

Health care transitions for adolescents with congenital heart disease: patient and family perspectives.

Advances in medical management and surgical treatment have improved the longevity and quality of life for patients with CHD. However, meeting the health care needs of this growing population has not kept pace with the advances in technology. Adolescents with CHD are caught between both childhood and adulthood and pediatric and adult cardiology. As health care providers develop strategies to meet the special health care transition needs of this group, patient and family perspectives must be understood and included in the transition plan if one is to develop meaningful interventions. Assessment and recognition of the developmental changes occurring for both adolescents and their families and the impact of chronic illness on these changes are critical if transition is to be successful. Expectations,individual biases, and negative stereotypes need to be recognized and reframed if one is to establish an empathetic, positive, and trusting relationship with patients and their families. Greater sensitivity also needs to be given to the shifting roles, responsibilities, and inherent losses that occur with transition. Nurses have a key role in guiding patients and families toward adult, independent self-care by helping them identify and use their talents and resources as they move toward achieving their goals and dreams for the future.

Adaptation, Psychological↗
PubMed2004

Neonatal transitional care.

Challenging times lay ahead for very low birth weight (VLBW) infants and their families after hospital discharge. Ongoing medical concerns, respiratory complications, breastfeeding and feeding problems, inadequate growth and delayed development are frequently encountered by this vulnerable population. Families are burdened by the worry and work of caring for their VLBW infants at home. Specialized support in the community is needed to help in the transition of infants and families from hospital to home. The Neonatal Transitional Care Program (NTCP) commenced in 1997 to assist homeward bound VLBW infants and their families in the Calgary Health Region. The program team, consisting of clinical nurse specialists and a dietitian, provides in-home and telephone support for four months after infants are discharged. Extensive program evaluations reveal lengthened breast milk provision, decreased demand on healthcare resources (particularly emergency departments and pediatrician offices) and enhanced maternal confidence and satisfaction with community service. In this article, the development and evaluation of the NTCP are described. This innovative approach to caring for a vulnerable population of VLBW infants and their families is believed to be the first of its kind in North America. The NTCP models neonatal care that is seamless across the healthcare system and congruent with the needs of the infant and family.

Alberta↗
PubMed1995

The medical director in hospital-based transitional care units.

This article begins with a brief overview of what subacute care is and why it is growing exponentially. It then discusses the characteristics of patients appropriate for treatment in a transitional care unit (TCU) and the evolving role of physicians in their care. The process of care in a typical hospital-based TCU from admission to discharge is discussed with an emphasis on documentation and an interdisciplinary approach. The role of the medical director is emphasized. The article closes with strategies the authors feel are useful for improving care in hospital-based TCUs.

Aged↗
PubMed1999

[Transitional care in the course of nursing].

The present paper addresses human beings' transitionary events which permeate their vital cycle, as well as the conductive conditions to the transition processes and their care relations. It focuses on the several distinguishing types of transition and their conceptualizations throughout the scope of transitional care. Such care is concerned with the features of the events which derive change, as well as the individual variables and the context interacting with those features, facilitating the understanding of the interaction process and assimilation of the change. From that conceptualization, it targets the development of nursing interventions facing the transitional processes in the light of nursing theories, which can be re-stated in transition terms. Due to the variety of focuses, transition is related to nursing care and it aims at the prevention and intervention for each specific case, providing nurses with an innovative focus of care. It points out that care is somehow tied up to each developmental stage, favouring maturity and growth in the search for a larger balance and stability. Care facing transition brings about answers to the valuing of the being.

Humans↗
PubMed2005

Are family members suitable proxies for transitional care unit residents when collecting satisfaction information?

OBJECTIVE: To examine the agreement and association of elders' responses with family member proxy responses using the same, previously validated satisfaction instrument on both groups of respondents. METHODS: Satisfaction data came from transitional care unit residents and family members (N = 462 paired responses) from one facility and were collected between 1999 and 2000. The satisfaction questionnaire consisted of 17 items evaluating the art of care, technical quality, efficacy, amenities of the care environment, and global satisfaction. Bias indexes and intraclass correlation coefficients were used to examine the satisfaction scores. RESULTS: In general, proxy satisfaction ratings were higher than ratings of residents. The results also show that proxy ratings varied less from resident ratings for the amenity items, which were considered the most concrete items. Proxy ratings were much higher for the art of care and efficacy domain items, which were considered the least concrete items. CONCLUSION: The results of this investigation show that proxy ratings do not necessarily substitute for resident ratings.

Aftercare↗
PubMed2002

Palliative care--transiting old tradition and values into the modern health care practice.

Care of the dying patient is care for the patient who is still living, it is helping that patient to live his or her life to the fullest whether at home or hospice, or in hospital. It is care that is not just centered on the individual but includes members of the family. It is focused on improving the quality of patients' life, by incorporating into the professional care most of unique human values, such as respect, empathy, compassion and tender loving care. Palliative care is a broad band of care of indeterminate length, and does not necessarily end with the death of the patient. Until life begins to glow again, some surviving relatives may need support during the bereavement period. Thanks to Dr Elisabeth Kübler-Ross and Dame Cicely Saunders, two great women visionaries and leaders of the emergence of Palliative Care, one of the best things that has happened to medicine in the 20th century, the development of care for dying patients and their families was possible.

Home Care Services↗
PubMedDate not supplied

Transitional care: a multidisciplinary case management-based unit.

A major challenge confronting health professionals today is the provision of safe, effective, and quality care for patients with the available reimbursement funds. Multidisciplinary case management meets this challenge by providing planned, coordinated care based on patient needs. Children dependent on technology are logical choices for case management since they often experience prolonged hospitalization and require intervention from numerous specialists. To meet this need, LeBonheur Children's Medical Center in Memphis, Tennessee opened the Transitional Care Unit (TCU), which provides the family with a conducive environment for developmental, social, and educational interaction. A retrospective chart review on 10 patients was conducted to assess the efficiency of the unit. Findings demonstrated a decrease in daily costs and hospital stay. A TCU uses scarce hospital resources while efficiently saving health care funds for the individual patient.

Adolescent↗
PubMed2006

Challenges in transitional care between nursing homes and emergency departments.

OBJECTIVE: To obtain opinions of knowledgeable professionals involved in the emergency care of nursing home (NH) residents. DESIGN: Structured focus group interviews. PARTICIPANTS: Five provider categories, including NH staff, NH physicians and nurse practitioners, emergency medical services (EMS) providers, emergency department (ED) nurses, and ED physicians. SETTING: Two NHs, 2 EDs, and a county-wide EMS system. ANALYSIS: Audiotaped discussions were transcribed and analyzed independently by 2 authors. RESULTS: Themes included barriers to providing high-quality care, data needed when residents are transported in both directions between EDs and NHs, and possible solutions to improve care. Communication problems were the most frequently cited barrier to providing care. Residents are often transported in both directions without any written documentation; however, even when communication does occur, it is often not in a mode that is useable by the receiving provider. ED personnel need a small amount of organized, written information. When residents are released from the ED, NH personnel need a verbal report from ED nurses as well as written documentation. All groups were optimistic that communication can be improved. Ideas included use of (1) fax machines or audiotape cassette recorders to exchange information, (2) an emergency form in residents' charts that contains predocumented information with an area to write in the reason for transfer, and (3) brief NH-to-ED and ED-to-NH transfer forms that are accepted and used by local NHs and EDs. CONCLUSION: The transitional care of NH residents is laden with problems but has solutions that deserve additional development and investigation.

Emergency Service, Hospital↗
PubMed2006

Improving the retirement village to residential aged care transition.

Older Australians living in retirement villages are an increasing community segment. These people make choices both about the place at which they live and the support needed at that place to optimise health and wellbeing. However, for some, unmet support needs in the retirement village may result in a transition to a residential aged care facility. This qualitative study explored how and why this transition occurs; how it might be avoided; and, when the move is unavoidable, how the process can be improved. Implications of these findings for the retirement village and aged care sectors are discussed.

Aged↗
PubMedDate not supplied

New practices in the transitional care center improve outcomes for babies and their families.

Assuming sole responsibility of parenting a high-risk infant after a prolonged hospital stay can be a complex and traumatic event, especially when the infant is discharged with residual health care problems requiring medical management and treatment at home. A parent's ability to successfully transition the management of their infant's care from hospital to home depends on a collaborative discharge process where parents are ongoing, full participants. The Transitional Care Center environment makes learning comfortable for parents, allows parental care-giver mastery to occur, and fosters family integration. Favorable clinical outcomes concurrent with decreased lengths of hospital stays and readmission rates have been demonstrated.

Adult↗