Confronting Challenges in Reducing Heart Failure 30‐Day Readmissions: Lessons Learned With Implications for Evidence‐Based Practice

Wood, Racheal L.; Migliore, Laurie; Nasshan, Sandra J.; Mirghani, Sara R.; Contasti, Annette

doi:10.1111/wvn.12336

Cited by 8 publications

(28 citation statements)

References 18 publications

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“…A total of 203 (55%) included articles provided information on how the PARIHS framework was used in the evaluation of study findings, in terms of contributing to the discussion and interpretation of results [ 13 , 52 , 58 – 82 , 84 – 89 , 95 – 121 , 149 – 214 , 243 – 259 , 261 – 284 , 313 , 314 , 316 – 320 , 323 – 331 , 339 , 341 – 350 , 359 – 365 , 386 , 389 ]. The majority ( n = 167) of these were empirical studies [ 52 , 58 – 82 , 84 – 89 , 95 – 121 , 149 – 214 , 243 – 259 , 261 – 284 , 386 ].…”

Section: Resultsmentioning

confidence: 99%

“…Specifically, we found some empirical articles reported evaluating the PARIHS element “context” by means of context tools (e.g., [ 155 ]). In addition, an evaluation of the study findings using the framework was identified in 18 opinion/theoretical articles [ 339 , 341 – 350 , 359 – 365 ] and 18 empirical review studies [ 13 , 313 , 314 , 316 – 320 , 323 – 331 , 389 ]. Among the opinion/theoretical articles, there were papers evaluating other theoretical constructions in relation to the PARIHS framework (e.g., [ 364 ]).…”

Section: Resultsmentioning

confidence: 99%

“…Empirical studies using the PARIHS framework in the analysis encompassed primarily all three main elements of PARIHS (e.g., [166,181,193,221]) and the context domain (e.g., [78,152,153,207]), and in lesser extent the evidence (e.g., [185,208,214]) and the facilitation domain (e.g., [58,67,79,182]). Eleven review studies [13,313,314,[316][317][318][319][320][321][322]389] used the framework for the analysis; findings were mapped to PARIHS elements in a few studies [316,317,389]; one described that their data had been "analysed through the lens of PARIHS" (p1) [389]. A couple of the review studies had PARIHS as the object for analysis, comparing it with other frameworks [318,322].…”

Section: The Application Of Parihs In Data Analysismentioning

confidence: 99%

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The use of the PARIHS framework in implementation research and practice—a citation analysis of the literature

et al. 2020

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Background: The Promoting Action on Research Implementation in Health Services (PARIHS) framework was developed two decades ago and conceptualizes successful implementation (SI) as a function (f) of the evidence (E) nature and type, context (C) quality, and the facilitation (F), [SI = f (E,C,F)]. Despite a growing number of citations of theoretical frameworks including PARIHS, details of how theoretical frameworks are used remains largely unknown. This review aimed to enhance the understanding of the breadth and depth of the use of the PARIHS framework. Methods: This citation analysis commenced from four core articles representing the key stages of the framework's development. The citation search was performed in Web of Science and Scopus. After exclusion, we undertook an initial assessment aimed to identify articles using PARIHS and not only referencing any of the core articles. To assess this, all articles were read in full. Further data extraction included capturing information about where (country/ countries and setting/s) PARIHS had been used, as well as categorizing how the framework was applied. Also, strengths and weaknesses, as well as efforts to validate the framework, were explored in detail. Results: The citation search yielded 1613 articles. After applying exclusion criteria, 1475 articles were read in full, and the initial assessment yielded a total of 367 articles reported to have used the PARIHS framework. These articles were included for data extraction. The framework had been used in a variety of settings and in both high-, middle-, and low-income countries. With regard to types of use, 32% used PARIHS in planning and delivering an intervention, 50% in data analysis, 55% in the evaluation of study findings, and/or 37% in any other way. Further analysis showed that its actual application was frequently partial and generally not well elaborated. Conclusions: In line with previous citation analysis of the use of theoretical frameworks in implementation science, we also found a rather superficial description of the use of PARIHS. Thus, we propose the development and adoption of reporting guidelines on how framework(s) are used in implementation studies, with the expectation that this will enhance the maturity of implementation science.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: The Application Of Parihs In Data Analysismentioning

confidence: 99%

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The use of the PARIHS framework in implementation research and practice—a citation analysis of the literature

et al. 2020

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“…[ 4 – 6 ] Several other independent studies evaluated admissions based on specific disease states or surgeries such as heart failure, sepsis, chronic obstructive lung disease, heart valve surgery, and spine surgery. [ 7 – 11 ] However, relatively few studies have assessed whether or not traits of the physicians caring for the patients influence readmission rates as well. The current study attempts to address this literature gap.…”

Section: Introductionmentioning

confidence: 99%

Physician characteristics correlate with hospital readmission rates

Skolka

Lehman²,

Khalid

et al. 2020

Medicine

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Hospital readmission rates are used as a metric to measure quality patient care. While several tools predict readmissions based on patient-specific characteristics, this study assesses if physician characteristics correlate with hospital readmission rates. In a 5-year retrospective electronic record review at a single institution, 31 internal medicine attending physicians’ discharges were tracked for a total of 70 physician years, and 15,933 hospital discharges. Each physician's yearly 7-day, 8 to 30-day, and 30-day readmission rates were compared. Each rate was also correlated with years of post-graduate clinical experience, discharge volume, physician sex, and fiscal year. Individual physicians had significantly different 7-day, 8 to 30-day, and 30-day readmission rates from each other. The rates were not related to sex, years after post-graduate training, or fiscal year. However, physician patient volume correlated with 7-day readmission rates. Physicians who discharged ≤100 patients per year had a higher 7-day readmission rate than physicians who discharged >100 patients per year. This correlation with patient volume did not hold for the 8 to 30-day and 30-day readmission rates. Individual physicians differ in their patient readmission rates in 7-day, 8 to 30-day, and 30-day categories. A critical level of a physician's hospital activity, as reflected by the number of patient discharges per year (>100), results in lower 7-day readmission rates. Sex, post-graduate years of clinical experience, and fiscal year did not play a role. The lack of correlation between each physicians’ 7-day and 8 to 30-day readmission rates suggests that different physician factors are involved in these 2 rates.

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“…Many studies, however, show that patients are not able to cope with the impacts of the disease and they do not adjust to their new life situation. [1][2][3] Despite the progress in the development of methods of pharmacological treatment of heart failure, professionals interviewed on multidisciplinary disease management pilot projects.…”

Section: Introductionmentioning

confidence: 99%

Educational interventions for patients with heart failure: a systematic review of randomized controlled trials

et al. 2019

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Background: Patient education is an important intervention for the management of heart failure; however, in practice patient education varies considerably. The purpose is to systematically review educational interventions that have been implemented for heart failure patients and assess their effectiveness.Method and Material: Randomized controlled trials from 2008 to 2018 in MEDLINE were reviewed using the following search terms: nursing teaching, education, intervention, patients with heart failure, hospital. From the Randomized controlled trials 26 abstracts were reviewed.Results: A total of 2484 patients were included in the 19 studies that met the inclusion criteria. Commonly, the initial educational intervention was a one-on-one didactic session conducted by nurses supplemented by written materials and multimedia approaches. One study referred to a theoretical model as a framework for their educational intervention. Studies used a variety of outcome measures to evaluate their effectiveness. Of the studies reviewed, 17 demonstrated a significant effect from their intervention in at least one of their outcome measures.Conclusions: Despite improvements in knowledge, we have variable results in outcomes and this is very likely related to the heterogeneity of the studies included in this review. It was difficult to establish the most effective educational strategy as the educational interventions varied considerably in delivery methods and duration as well as the outcome measures that were used for the evaluation. A patient-centered multidisciplinary approach based on educational theory and evaluated appropriately may assist to develop an evidence base for patient education.

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Confronting Challenges in Reducing Heart Failure 30‐Day Readmissions: Lessons Learned With Implications for Evidence‐Based Practice

Cited by 8 publications

References 18 publications

The use of the PARIHS framework in implementation research and practice—a citation analysis of the literature

The use of the PARIHS framework in implementation research and practice—a citation analysis of the literature

Physician characteristics correlate with hospital readmission rates

Educational interventions for patients with heart failure: a systematic review of randomized controlled trials

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