The Untold Story of Being Designated an Alternate Level of Care Patient

Jarrett, Pamela; Stewart, Connie

doi:10.12927/hcpol.2015.24364

Cited by 17 publications

(46 citation statements)

References 16 publications

(19 reference statements)

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“…The characteristics of the included articles are presented in Table . Of the seven included articles, five had qualitative study designs and two were mixed‐methods studies . Of the qualitative studies, the majority employed interviews (n = 4) and one employed ethnography .…”

Section: Resultsmentioning

confidence: 99%

“…Most articles (n = 5) provided a definition of delayed discharge or alternate level of care . Of the five studies that provided a definition for delayed discharge, four described patients as being either medically stable and cleared for discharge or no longer needing the intensity of service provided in their current setting . The remaining article described delayed discharge as a situation ‘when a patient is inappropriately occupying a hospital bed’ .…”

Section: Resultsmentioning

confidence: 99%

“…One article included only male participants and the ethnographic study contained three detailed case reports of three female participants. In the four articles that reported the age of patient participants, all were above 80 years old . Four studies used a minimum age as inclusion criteria for selecting patient participants .…”

Section: Resultsmentioning

confidence: 99%

“…In regard to health conditions of patients, four articles reported the primary condition or event resulting in patient hospitalization. These were most commonly mental illness or neurological/brain injuries (n = 11), falls (n = 9) or cardiovascular conditions (n = 4) . None of the included articles described patients’ secondary conditions or multimorbidity.…”

Section: Resultsmentioning

confidence: 99%

“…The majority of the articles (n = 6) reported some information on the type of hospital in which participants were waiting; however, there was little consistency in the descriptions provided. All but one of the included articles described the planned destination for at least some of the patient following hospitalization . These destinations were most frequently assisted‐living, long‐term care or nursing homes.…”

Section: Resultsmentioning

confidence: 99%

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Patient and caregiver experience with delayed discharge from a hospital setting: A scoping review

Everall

Guilcher

Cadel

et al. 2019

Health Expectations

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BackgroundDelayed hospital discharge occurs when patients are medically cleared but remain hospitalized because a suitable care setting is not available. Delayed discharge typically results in reduced levels of treatment, placing patients at risk of functional decline, falls and hospital‐related adverse events. Caregivers often take on an active role in hospital to mitigate these risks.ObjectiveThis scoping review aimed to summarize the literature on patient and caregiver experiences with delayed hospital discharge.Search strategySeven electronic databases and grey literature were searched using keywords including alternate level of care, delayed discharge, patients, caregivers and experiences.Inclusion criteriaIncluded articles met the following criteria: (a) patient or caregiver population 18 years or older; (b) delayed discharge from a hospital setting; (c) included experiences with delayed discharge; (d) peer‐reviewed or grey literature; and (e) published between 1 January 1998 and 16 July 2018.Data extractionData were extracted from the seven included articles using Microsoft Excel 2016 to facilitate a thorough analysis and comparison.Main resultsStudy themes were grouped into five elements of the delayed discharge experience: (1) overall uncertainty; (2) impact of hospital staff and physical environment; (3) mental and physical deterioration; (4) lack of engagement in decision making and need for advocacy; and (5) initial disbelief sometimes followed by reluctant acceptance.ConclusionThis review provides a foundation to guide future research, policies and practices to improve patient and caregiver experiences with delayed hospital discharge, including enhanced communication with patients and families and programmes to reduce deconditioning.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Patient and caregiver experience with delayed discharge from a hospital setting: A scoping review

Everall

Guilcher

Cadel

et al. 2019

Health Expectations

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Transitional care programs in Canada for older adults transitioning from hospital to home: protocol for a systematic review of text and opinion

Barber

Gregg

Macdonald

et al. 2022

JBI Evidence Synthesis

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Objective: The objective of this systematic review is to identify what transitional care programs exist across Canada, including the characteristics and outcomes of these programs. Introduction: There is growing evidence of the benefits of transitional care programs to support older adults moving from hospital to home. However, there is limited literature identifying the types of transitional care programs that exist internationally and little evidence available within Canada. Inclusion criteria: Sources of gray literature published from 2016 that focus on older adults receiving services from transitional care programs to move from hospital to home in Canada will be considered for inclusion. Sources of gray literature will be excluded if interventions are targeted at adults younger than 65 years, Indigenous adults younger than 55 years, or if the primary discharge destination is not an independent community dwelling. Interventions designed for older adults waiting in hospital for long-term care placement will also be excluded from this review. Methods: An initial limited search of Canadian national gray literature resources will be undertaken, followed by an advanced Google search of Canadian resources and news media reports. Lastly, an advanced search of Google for all 10 provinces and 3 territories will be undertaken to target examples of local transitional care programs that may not be found through a national search, such as local pilot projects, health region–specific programs, and provincial organizations. All identified sources will be retrieved and full text review of selected citations assessed in detail by 2 independent reviewers. Data about the characteristics and outcomes of transitional care programs and results will be extracted and synthesized, with a meta-aggregation approach for grading according to JBI ConQual method. Systematic review registration number: PROSPERO CRD42022298821

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Initiatives for improving delayed discharge from a hospital setting: a scoping review

et al. 2021

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ObjectiveThe overarching objective of the scoping review was to examine peer reviewed and grey literature for best practices that have been developed, implemented and/or evaluated for delayed discharge involving a hospital setting. Two specific objectives were to review what the delayed discharge initiatives entailed and identify gaps in the literature in order to inform future work.DesignScoping review.MethodsElectronic databases and websites of government and healthcare organisations were searched for eligible articles. Articles were required to include an initiative that focused on delayed discharge, involve a hospital setting and be published between 1 January 2004 and 16 August 2019. Data were extracted using Microsoft Excel. Following extraction, a policy framework by Doern and Phidd was adapted to organise the included initiatives into categories: (1) information sharing; (2) tools and guidelines; (3) practice changes; (4) infrastructure and finance and (5) other.ResultsSixty-six articles were included in this review. The majority of initiatives were categorised as practice change (n=36), followed by information sharing (n=19) and tools and guidelines (n=19). Numerous initiatives incorporated multiple categories. The majority of initiatives were implemented by multidisciplinary teams and resulted in improved outcomes such as reduced length of stay and discharge delays. However, the experiences of patients and families were rarely reported. Included initiatives also lacked important contextual information, which is essential for replicating best practices and scaling up.ConclusionsThis scoping review identified a number of initiatives that have been implemented to target delayed discharges. While the majority of initiatives resulted in positive outcomes, delayed discharges remain an international problem. There are significant gaps and limitations in evidence and thus, future work is warranted to develop solutions that have a sustainable impact.

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The Untold Story of Being Designated an Alternate Level of Care Patient

Cited by 17 publications

References 16 publications

Patient and caregiver experience with delayed discharge from a hospital setting: A scoping review

Patient and caregiver experience with delayed discharge from a hospital setting: A scoping review

Transitional care programs in Canada for older adults transitioning from hospital to home: protocol for a systematic review of text and opinion

Initiatives for improving delayed discharge from a hospital setting: a scoping review

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