Reducing emergency department presentations among chronically ill patients in Western Sydney: a key role for coordinated primary care

Mallitt, Kylie‐Ann; McNab, Justin; Hughes, Rod; Fernyhough, Joanne; Paterson, J; O'Halloran, Di

doi:10.1071/py16012

Cited by 9 publications

(13 citation statements)

References 7 publications

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“…This coordinator role linked to improved collaboration has been recognised in other studies (e.g. Aspinal et al, 2012; Karam et al, 2018; Mallit et al, 2017; Prasad et al, 2014). In the Conditions, dimension nurses suggested that collaboration learning opportunities were insufficient.…”

Section: Discussionmentioning

confidence: 65%

“…In this collaboration, the nurses value and understand their own roles, responsibilities and work environment as well as those in partnership (Emich, 2018; Lemetti et al, 2015, 2017; Moore et al, 2019; Morley & Cashell, 2017). There are some specific nurses' roles reported in the literature, requiring these collaboration skills including, discharge coordination (Lemetti et al, 2017) and liaison nursing roles (Mallit et al, 2017; Pittman & Forrest, 2015; Ribas et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

“…The dimension of the Consequences of collaboration between nurses in working hospital and primary health care includes: older people's satisfaction with health care (Lemetti et al, 2017); the smooth transfer of care (Lemetti et al, 2015, 2017, 2019; Prasad et al, 2014); the continuity of care (Lemetti et al, 2015, 2017; Prasad et al, 2014); and networking between nurses (Lemetti et al, 2017; Mallit et al, 2017). To collaborate well, nurses' roles and responsibilities are clearly defined (Lemetti et al, 2017, 2019) and the expertise of nurses is recognised and utilised (Lemetti et al, 2017).…”

Section: Introductionmentioning

confidence: 99%

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Nurse‐to‐nurse collaboration between nurses caring for older people in hospital and primary health care: A cross‐sectional study

Lemetti

Puukka

Stolt

et al. 2021

Journal of Clinical Nursing

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Aims and objectives To assess the level of nurse‐to‐nurse collaboration during the transfer of older people between hospital and primary health care and to evaluate the psychometric properties of the newly developed Nurse‐to‐Nurse Collaboration Between Sectors Instrument. Background Nurse‐to‐nurse collaboration is required when older people transfer between hospital and primary health care to enhance the safety and continuity of care to patients. There is a lack of evidence about the nature and level of this collaboration. Design A cross‐sectional survey design was used. This study adhered to the STROBE checklist. Methods A sample of 443 nurses (university hospital n = 240, primary health care n = 203) participated in the study from October 2017 to June 2018. Nurses completed the Nurse‐to‐Nurse Collaboration Between Sectors Instrument (86 items, 7–point Likert‐type scale), the Nurse‐Nurse Collaboration Scale and the Patient‐Centred Competency Scale. Results Nurses rated the overall level of nurse‐to‐nurse collaboration moderately high (mean=4.49, standard deviation=0.83, maximum 7.00). Nurses considered collaboration an important and confidential process, gaining older people's trust in their care. Lower scores were given to the agreement of mutual objectives, policies and guidelines in collaboration, opportunities for job rotation and interacting and networking during the collaboration process. The internal consistency reliability of the newly developed instrument was acceptable. Conclusions Nurses collaborate with competence and confidentiality during the transfer of older people between care settings. However, there is a need for more opportunities to collaborate, to obtain mutual agreement about objectives, policies and practices, and better understand other nurse's roles and responsibilities in collaboration. The reliability and validity of the Nurse‐to‐Nurse Collaboration Between Sectors Instrument were acceptable though the number and wording of items will be reviewed and further tested. Relevance to clinical practice Nurses need opportunities to collaborate, and there is a need to develop agreed objectives, practices, roles and responsibilities in this collaboration.

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Section: Discussionmentioning

confidence: 65%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Nurse‐to‐nurse collaboration between nurses caring for older people in hospital and primary health care: A cross‐sectional study

Lemetti

Puukka

Stolt

et al. 2021

Journal of Clinical Nursing

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“…A SCIPPS evaluation of a New South Wales Ministry of Health program, which was designed to better coordinate such care through a specialist liaison nurse role, showed promise. 33,34 GPs, community health centre staff and management all reported improved coordination of services, and better integrated health and social care. 35,36 Defined, but flexible, policy aims and objectives assisted in establishing and meeting local needs and priorities.…”

Section: Implications For Australian Gpsmentioning

confidence: 99%

The experiences of patients and carers living with multimorbid, non-communicable diseases

Leeder¹,

Jowsey

McNab

2018

Aust J Gen Pract

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“…There is a growing body of evidence that in order to be effective, in-depth interventions are required [ 1 ]. Intervention should reach beyond the traditional boundaries of intra-hospital care to embrace multi-disciplinary case management, providing care which is proactive and which is planned and delivered in the community [ 8 9 10 ]. Further, the case has been made for collaborative, whole system care in which navigation of both the medical and social sectors is required.…”

Section: Introductionmentioning

confidence: 99%

The Checkpoint Program: Collaborative Care to Reduce the Reliance of Frequent Presenters on ED

Baird

Oytam²,

Rahman

et al. 2021

International Journal of Integrated Care

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Introduction: Growing pressures upon Emergency Departments [ED] call for new ways of working with frequent presenters who, although small in number, place extensive demands on services, to say nothing of the costs and consequences for the patients themselves. EDs are often poorly equipped to address the multi-dimensional nature of patient need and the complex circumstances surrounding repeated presentation. Employing a model of intensive short-term community-based case management, the Checkpoint program sought to improve care coordination for this patient group, thereby reducing their reliance on ED.Method: This study employed a single group interrupted time series design, evaluating patient engagement with the program and year-on-year individual differences in the number of ED visits pre and post enrolment. Associated savings were also estimated.Results: Prior to intervention, there were two dominant modes in the ED presentation trends of patients. One group had a steady pattern with ≥7 presentations in each of the last four years. The other group had an increasing trend in presentations, peaking in the 12 months immediately preceding enrolment. Following the intervention, both groups demonstrated two consecutive year-on-year reductions. By the second year, and from an overall peak of 22.5 presentations per patient per annum, there was a 53% reduction in presentations. This yielded approximate savings of $7100 per patient.Discussion: Efforts to improve care coordination, when combined with proactive case management in the community, can impact positively on ED re-presentation rates, provided they are concerted, sufficiently intensive and embed the principles of integration. Conclusion:The Checkpoint program demonstrated sufficient promise to warrant further exploration of its sustainability. However, health services have yet to determine the ideal organisational structures and funding arrangements to support such initiatives.

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Reducing emergency department presentations among chronically ill patients in Western Sydney: a key role for coordinated primary care

Cited by 9 publications

References 7 publications

Nurse‐to‐nurse collaboration between nurses caring for older people in hospital and primary health care: A cross‐sectional study

Nurse‐to‐nurse collaboration between nurses caring for older people in hospital and primary health care: A cross‐sectional study

The experiences of patients and carers living with multimorbid, non-communicable diseases

The Checkpoint Program: Collaborative Care to Reduce the Reliance of Frequent Presenters on ED

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