Purpose Peer support programmes that provide services for various health conditions have been in existence for many years; however, there is little study of their benefits and challenges. Our goal was to explore how existing peer support programmes help patients with a variety of health conditions, the challenges that these programmes meet, and how they are addressed. Methods We partnered with 7 peer support programmes operating in healthcare and community settings and conducted 43 semi-structured interviews with key informants. Audiorecordings were transcribed and qualitative analysis was conducted using grounded theory methods. Results Peer support programmes offer informational and psychosocial support, reduce social isolation, and connect patients and caregivers to others with similar health issues. These programmes provide a supportive community of persons who have personal experience with the same health condition and who can provide practical information about self-care and guidance in navigating the health system. Peer support is viewed as different from and complementary to professional healthcare services. Existing programmes experience challenges such as matching of peer supporter and peer recipient and maintaining relationship boundaries. They have gained experience in addressing some of these challenges. Conclusions Peer support programmes can help persons and caregivers manage health conditions but also face challenges that need to be addressed through organizational processes. Peer support programmes have relevance for improving healthcare systems, especially given the increased focus on becoming more patient-centred. Further study of peer programmes and their relevance to improving individuals’ well-being is warranted.
Objective To compare the Agency for Healthcare Research and Quality's Quality and Safety Review System (QSRS) and the proposed triadic structure for the 11th version of the International Classification of Disease (ICD‐11) in their ability to capture adverse events in U.S. hospitals. Data Sources/Study Setting One thousand patient admissions between 2014 and 2016 from three general, acute care hospitals located in Maryland and Washington D.C. Study Design The admissions chosen for the study were a random sample from all three hospitals. Data Collection/Extraction Methods All 1000 admissions were abstracted through QSRS by one set of Certified Coding Specialists and a different set of coders assigned the draft ICD‐11 codes. Previously assigned ICD‐10‐CM codes for 230 of the admissions were also used. Principal Findings We found less than 20 percent agreement between QSRS and ICD‐11 in identifying the same adverse event. The likelihood of a mismatch between QSRS and ICD‐11 was almost twice that of a match. The findings were similar to the agreement found between QSRS and ICD‐10‐CM in identifying the same adverse event. When coders were provided with a list of potential adverse events, the sensitivity and negative predictive value of ICD‐11 improved. Conclusions While ICD‐11 may offer an efficient way of identifying adverse events, our analysis found that in its draft form, it has a limited ability to capture the same types of events as QSRS. Coders may require additional training on identifying adverse events in the chart if ICD‐11 is going to prove its maximum benefit.
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