Cardiac Transitional Care Effectiveness: Does Overall Comorbidity Burden Matter?

Garfein, Joshua; Cholack, George; Krallman, Rachel; Feldeisen, Delaney; Montgomery, Daniel; Kline–Rogers, Eva; Eagle, Kim A.; Rubenfire, Melvyn; Bumpus, Sherry M

doi:10.1016/j.amjmed.2021.06.018

Cited by 3 publications

(8 citation statements)

References 24 publications

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“…Eleven studies had experimental designs, including eight quasi-experimental studies (Christianson-Silva et al, 2021; Hummel et al, 2017; Kobb et al, 2003; Lenaghan, 2019; Mailliard et al, 2019; Mallow et al, 2018; Sharma et al, 2013; Talley et al, 2021) and three RCTs (Druss et al, 2017; Litaker et al, 2003; Zulman et al, 2017). Four studies used observational design including two cohort studies (Garfein et al, 2021; Morgan et al, 2019) and two cross-sectional studies (Chou et al, 2021; Fraze et al, 2020). Data extraction is summarized in Table 1.…”

Section: Resultsmentioning

confidence: 99%

“…Primary care clinicians or discharging teams identified these patients and referred them to an NP who provided supplementary primary care services tailored to their specific needs. The targeted services included goal setting (Hummel et al, 2017), care coordination among patients’ providers (Garfein et al, 2021; Hummel et al, 2017; Lenaghan, 2019; Zulman et al, 2017), telehealth services (Kobb et al, 2003), and medication review (Mailliard et al, 2019).…”

Section: Resultsmentioning

confidence: 99%

“…On the contrary, one cross-sectional study of Medicare beneficiaries in 2017 (Fraze et al, 2020) and the RCT of high-risk Veterans Health Administration patients (Zulman et al, 2017) found that NP care was associated with equivalent hospitalization rates compared with physician care or pre-intervention measurements, respectively. Furthermore, one cohort study of cardiac patients with high Charlson Comorbidity Index scores found that NP primary care was associated equivalent rates of hospital readmission compared with baseline data (Garfein et al, 2021).…”

Section: Discussionmentioning

confidence: 99%

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A Systematic Review of Outcomes Related to Nurse Practitioner-Delivered Primary Care for Multiple Chronic Conditions

McMenamin

Turi

Schlak³

et al. 2023

Med Care Res Rev

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Multiple chronic conditions (MCCs) are more common and costly than any individual health condition in the United States. The growing workforce of nurse practitioners (NPs) plays an active role in providing primary care to this patient population. This study identifies the effect of NP primary care models, compared with models without NP involvement, on cost, quality, and service utilization by patients with MCCs. We conducted a literature search of six databases and performed critical appraisal. Fifteen studies met inclusion criteria (years: 2003–2021). Overall, most studies showed reduced or similar costs, equivalent or better quality, and similar or lower rates of emergency department use and hospitalization associated with NP primary care models for patients with MCCs, compared with models without NP involvement. No studies found them associated with worse outcomes. Thus, NP primary care models, compared with models without NP involvement, have similar or positive impacts on MCC patient outcomes.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

A Systematic Review of Outcomes Related to Nurse Practitioner-Delivered Primary Care for Multiple Chronic Conditions

McMenamin

Turi

Schlak³

et al. 2023

Med Care Res Rev

View full text Add to dashboard Cite

show abstract

“…In this cohort, the readmissions were because of infections and acute neurological events, and it is likely that these readmissions could not have been prevented by a clinic appointment. In many other specialties, readmissions are preventable with transitional care to focus on guideline directed medical treatment, such as in heart failure (Garfein et al, 2021). However, in this neurocritical care population, often the readmissions follow a predictable clinical trajectory, such as with evolution of SDH.…”

Section: Readmission Avoidancementioning

confidence: 99%

“…The Agency for Health care Research and Quality reported that neurological hospital admissions have a 14% readmission rate in U.S. hospitals between 2010 and 2016 (Bailey et al, 2019). Data show that posthospital follow-up within 7–14 days is optimal to prevent readmissions (Centers for Medicare & Medicaid Services, 2021a,b; Garfein et al, 2021; Lee, 2017; McClain & Chance, 2020).…”

Section: Introductionmentioning

confidence: 99%

Transitions in care: Piloting a neurocritical care clinic with nurse practitioners and physician associates

Michaelis,

Hundt,

Lombardi

et al. 2023

J Am Assoc Nurse Pract

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The transition period from hospital to home is a vulnerable time for rehospitalization and adverse events for patients. Follow-up clinic visits within 7–14 days of discharge is an effective strategy for reducing hospital readmissions. Neurocritical care patients have a unique set of needs to safely transition to home. We evaluated the feasibility of a Neuroscience Rapid Follow-Up Clinic with nurse practitioners (NPs) and physician associates (PAs) to meet transitional care gaps in neurocritical care patients and prevent rehospitalization. Clinic procedures and documentation templates were customized for the pilot clinic. Five NPs and one PA underwent a brief training course for the ambulatory care setting. Eligible patients were tracked throughout the hospitalization and the team made follow-up appointments. The pilot clinic took place from October 2022 to January 2023. Nine patients were seen in the clinic approximately 8 days after discharge. The clinic attendance rate was 90%. Among the clinic attendees, 66% received referrals to a primary care provider or other services, one third received medication changes or refills and all received patient-specific education. There were no rehospitalizations among the clinic patients. Implementation of this pilot clinic was possible with the current departmental resources. This innovative model of care has the potential to reduce hospital readmissions.

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Care Transitions Intervention and Other Non-nursing Home Transitions Models

Thomas,

Jones

2024

Geriatrics Models of Care

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Cardiac Transitional Care Effectiveness: Does Overall Comorbidity Burden Matter?

Cited by 3 publications

References 24 publications

A Systematic Review of Outcomes Related to Nurse Practitioner-Delivered Primary Care for Multiple Chronic Conditions

A Systematic Review of Outcomes Related to Nurse Practitioner-Delivered Primary Care for Multiple Chronic Conditions

Transitions in care: Piloting a neurocritical care clinic with nurse practitioners and physician associates

Care Transitions Intervention and Other Non-nursing Home Transitions Models

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