| A systematic review and qualitative analysis to inform the development of a new emergency department-based geriatric case management model. | |
| | |
MedLine Citation:
|
PMID: 21621093 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
|
STUDY OBJECTIVE: We inform the future development of a new geriatric emergency management practice model. We perform a systematic review of the existing evidence for emergency department (ED)-based case management models designed to improve the health, social, and health service utilization outcomes for noninstitutionalized older patients within the context of an index ED visit. METHODS: This was a systematic review of English-language articles indexed in MEDLINE and CINAHL (1966 to 2010), describing ED-based case management models for older adults. Bibliographies of the retrieved articles were reviewed to identify additional references. A systematic qualitative case study analytic approach was used to identify the core operational components and outcome measures of the described clinical interventions. The authors of the included studies were also invited to verify our interpretations of their work. The determined patterns of component adherence were then used to postulate the relative importance and effect of the presence or absence of a particular component in influencing the overall effectiveness of their respective interventions. RESULTS: Eighteen of 352 studies (reported in 20 articles) met study criteria. Qualitative analyses identified 28 outcome measures and 8 distinct model characteristic components that included having an evidence-based practice model, nursing clinical involvement or leadership, high-risk screening processes, focused geriatric assessments, the initiation of care and disposition planning in the ED, interprofessional and capacity-building work practices, post-ED discharge follow-up with patients, and evaluation and monitoring processes. Of the 15 positive study results, 6 had all 8 characteristic components and 9 were found to be lacking at least 1 component. Two studies with positive results lacked 2 characteristic components and none lacked more than 2 components. Of the 3 studies with negative results demonstrating no positive effects based on any outcome tested, one lacked 2, one lacked 3, and one lacked 4 of the 8 model components. CONCLUSION: Successful models of ED-based case management models for older adults share certain key characteristics. This study builds on the emerging literature in this area and leverages the differences in these models and their associated outcomes to support the development of an evidence-based normative and effective geriatric emergency management practice model designed to address the special care needs and thereby improve the health and health service utilization outcomes of older patients. |
| | |
Authors:
|
Samir K Sinha; Edward S Bessman; Neal Flomenbaum; Bruce Leff |
Related Documents
:
|
23683753 - Improving epidemiologic data analyses through multivariate regression modelling. 7317573 - A comparison of intravenous and subarachnoid lidocaine pharmacokinetics in the rhesus m... 19468053 - Using chemical organization theory for model checking. |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: Annals of emergency medicine Volume: 57 ISSN: 1097-6760 ISO Abbreviation: Ann Emerg Med Publication Date: 2011 Jun |
Date Detail:
|
Created Date: 2011-05-30 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 8002646 Medline TA: Ann Emerg Med Country: United States |
Other Details:
|
Languages: eng Pagination: 672-82 Citation Subset: AIM; IM |
Copyright Information:
|
Copyright © 2010 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved. |
Affiliation:
|
Division of Geriatric Medicine, University of Toronto, Toronto, Ontario, Canada; Division of Geriatric Medicine and Gerontology, Center on Aging and Health, Johns Hopkins University School of Medicine, Baltimore, MD. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Critical issues in the evaluation and management of adult patients presenting to the emergency depar...
Next Document: Evaluation of glomerular filtration rate with magnetic resonance imaging.