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Transitions of Care

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1. Impact of medication reconciliation for improving transitions of care. Full Text available with Trip Pro

Impact of medication reconciliation for improving transitions of care. Transitional care provides for the continuity of care as patients move between different stages and settings of care. Medication discrepancies arising at care transitions have been reported as prevalent and are linked with adverse drug events (ADEs) (e.g. rehospitalisation).Medication reconciliation is a process to prevent medication errors at transitions. Reconciliation involves building a complete list of a person's (...) this intervention during care transitions compared to people not receiving medication reconciliation.We searched CENTRAL, MEDLINE, Embase, seven other databases and two trials registers on 18 January 2018 together with reference checking, citation searching, grey literature searches and contact with study authors to identify additional studies.We included only randomised trials. Eligible studies described interventions fulfilling the Institute for Healthcare Improvement definition of medication reconciliation

2018 Cochrane

2. Transition between inpatient hospital settings and community or care home settings for adults with social care needs

Transition between inpatient hospital settings and community or care home settings for adults with social care needs T T r ransition between inpatient hospital ansition between inpatient hospital settings and community or care home settings and community or care home settings for adults with social care needs settings for adults with social care needs NICE guideline Published: 1 December 2015 nice.org.uk/guidance/ng27 © NICE 2019. All rights reserved. Subject to Notice of rights (https (...) due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties. Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible. Transition between inpatient

2015 National Institute for Health and Clinical Excellence - Clinical Guidelines

3. How can health care workers help young people not in employment education or training (NEETs) transition into work?

How can health care workers help young people not in employment education or training (NEETs) transition into work? Knowledge & Library Services (KLS) Evidence Briefing How can health care workers help young people not in employment, education or training (NEETs) transition into work? Caroline De Brún 15 th February 2018 How can health care workers help young people not in employment, education or training (NEETs) transition into work? KLS Evidence Briefing 15 th February 2018 Question (...) This briefing summarises the evidence, from the last twenty years, on how health care workers can help young people not in employment, education or training (NEETs) transition into work. Key messages ? The Organisation for Economic Co-operation and Development reported that across its member countries, 40 million young people were neither employed nor in education or training (NEET). ? When young people are not engaged in regular employment, education, or training, both their physical and mental health

2018 Public Health England - Evidence Briefings

4. Challenges faced by HIV-positive youth transitioning to adult care and evidence-based practices to address them

Challenges faced by HIV-positive youth transitioning to adult care and evidence-based practices to address them Challenges faced by HIV-positive youth transitioning to adult care and evidence-based practices to address them | The Ontario HIV Treatment Network The Ontario HIV Treatment Network Challenges faced by HIV-positive youth transitioning to adult care and evidence-based practices to address them Challenges faced by HIV-positive youth transitioning to adult care and evidence-based (...) practices to address them , , , , Questions What challenges arise when youth living with HIV transition to adult care? What evidence-based practices and resources facilitate successful transition to adult HIV care? Key take-home messages The barriers to successful transition to adult HIV care include lack of preparation, psychosocial stressors, loss of relationships, stigma, and barriers within the adult health care system (communication, distance to travel, differences from the pediatric environment

2018 Ontario HIV Treatment Network

5. Transitioning the Breastfeeding Preterm Infant from the Neonatal Intensive Care Unit to Home

Transitioning the Breastfeeding Preterm Infant from the Neonatal Intensive Care Unit to Home ABM Protocol ABM Clinical Protocol #12: Transitioning the Breastfeeding Preterm Infant from the Neonatal Intensive Care Unit to Home, Revised 2018 Lawrence M. Noble, 1 Adora C. Okogbule-Wonodi, 2 Michal A. Young, 2 and The Academy of Breastfeeding Medicine A central goal of the Academy of Breastfeeding Medicine is the development of clinical protocols, free from commercial interest or in?uence (...) , for managing common medical problems that may impact breastfeeding success. These protocols serve only as guidelines for the care of breastfeeding mothers and infants and do not delineate an exclusive course of treatment or serve as standards of medical care. Variations in treatment may be appropriate according to the needs of an individual patient. Introduction and Background T he practice of breastfeeding or providing expressed mother’s milk to preterm infants is promoted because of the considerable bene

2019 Academy of Breastfeeding Medicine

6. AACE/ACE Guidelines for Management of Growth Hormone Deficiency in Adults and Patients Transitioning from Pediatric to Adult Care

AACE/ACE Guidelines for Management of Growth Hormone Deficiency in Adults and Patients Transitioning from Pediatric to Adult Care ENDOCRINE PRACTICE Vol 25 No. 11 November 2019 1191 Copyright © 2019 AACE AACE 2019 Guidelines AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS AND AMERICAN COLLEGE OF ENDOCRINOLOGY GUIDELINES FOR MANAGEMENT OF GROWTH HORMONE DEFICIENCY IN ADULTS AND PATIENTS TRANSITIONING FROM PEDIATRIC TO ADULT CARE 2019 AACE GROWTH HORMONE TASK FORCE Kevin C. J. Yuen, MD, FRCP (...) (no clinical evidence). Conclusion: This CPG is a practical tool that prac- ticing endocrinologists and regulatory bodies can refer to regarding the identification, diagnosis, and treatment of adults and patients transitioning from pediatric to adult- care services with growth hormone deficiency (GHD). It provides guidelines on assessment, screening, diagnostic testing, and treatment recommendations for a range of individuals with various causes of adult GHD. The recom- mendations emphasize the importance

2019 American Association of Clinical Endocrinologists

7. Psychometric properties of transitional care instruments and their relationships with health literacy: Brief PREPARED and Care Transitions Measure. (Abstract)

Psychometric properties of transitional care instruments and their relationships with health literacy: Brief PREPARED and Care Transitions Measure. To assess the psychometric properties of the Brief PREPARED (B-PREPARED) and the Care Transitions Measure (CTM) in patients discharged from hospitals in Korea, and examine their relationships with health literacy.A cross-sectional study with a follow-up telephone survey 4 weeks post-discharge.Six medical and surgical wards in a tertiary hospital (...) variables, those with inadequate health literacy had lower scores on all instruments.Although the three instruments had acceptable validity and reliability, they showed limited criterion validity. Patients with limited health literacy should be supported to ensure the quality of transitional care.© The Author(s) 2019. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions

2019 International Journal for Quality in Health Care

8. Transition from children's to adults' services for young people using health or social care services

Transition from children's to adults' services for young people using health or social care services T T r ransition from children ansition from children’s to adults’ ’s to adults’ services for y services for young people using health or oung people using health or social care services social care services NICE guideline Published: 24 February 2016 nice.org.uk/guidance/ng43 © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and-conditions#notice (...) unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties. Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible. Transition from children’s to adults’ services for young people using

2016 National Institute for Health and Clinical Excellence - Clinical Guidelines

9. Transition between inpatient mental health settings and community or care home settings

Transition between inpatient mental health settings and community or care home settings T T r ransition between inpatient mental ansition between inpatient mental health settings and community or care health settings and community or care home settings home settings NICE guideline Published: 30 August 2016 nice.org.uk/guidance/ng53 © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and-conditions#notice-of- rights).Y Y our responsibility our (...) of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties. Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible. Transition between inpatient mental health settings and community or care home settings (NG53) © NICE 2019. All rights

2016 National Institute for Health and Clinical Excellence - Clinical Guidelines

10. Partners at Care Transitions: exploring healthcare professionals' perspectives of excellence at care transitions for older people. Full Text available with Trip Pro

Partners at Care Transitions: exploring healthcare professionals' perspectives of excellence at care transitions for older people. Hospital admissions are shorter than they were 10 years ago. Notwithstanding the benefits of this, patients often leave hospital requiring ongoing care. The transition period can therefore be risky, particularly for older people with complex health and social care needs. Previous research has predominantly focused on the errors and harms that occur during (...) transitions of care. In contrast, this study adopts an asset-based approach to learn from factors that facilitate safe outcomes. It seeks to explore how staff within high-performing ('positively deviant') teams successfully support transitions from hospital to home for older people.Six high-performing general practices and six hospital specialties that demonstrate exceptionally low or reducing 30-day emergency hospital readmission rates will be invited to participate in the study. Healthcare staff from

2018 BMJ open

11. Tele-transitions of care. A 12-month, parallel-group, superiority randomized controlled trial protocol, evaluating the use of telehealth versus standard transitions of care in the prevention of avoidable hospital readmissions Full Text available with Trip Pro

Tele-transitions of care. A 12-month, parallel-group, superiority randomized controlled trial protocol, evaluating the use of telehealth versus standard transitions of care in the prevention of avoidable hospital readmissions Comprehensive transitions of care, reduce dangerous hospital readmissions. Telehealth offers promise, however few guidelines aid clinicians in introducing it in a feasible way while addressing the needs of a multi-comorbid population. Physician adoptability remains (...) a significant barrier to the use of Telehealth due to data overload, concerns for disruptive workflows and uncertain practices. The methods proposed aid clinicians in implementing Telehealth training and research with limited resources to reach patients who need clinical surveillance most. This study introduces a new workflow for addressing tele-transitions of care, using risk stratification, remote patient monitoring, and patient-centered virtual visits. We propose a new communication tool which

2018 Contemporary clinical trials communications Controlled trial quality: uncertain

12. Health Care Transition Experiences of Males with Childhood-onset Duchenne and Becker Muscular Dystrophy: Findings from the Muscular Dystrophy Surveillance Tracking and Research Network (MD STARnet) Health Care Transitions and Other Life Experiences Survey Full Text available with Trip Pro

Health Care Transition Experiences of Males with Childhood-onset Duchenne and Becker Muscular Dystrophy: Findings from the Muscular Dystrophy Surveillance Tracking and Research Network (MD STARnet) Health Care Transitions and Other Life Experiences Survey Introduction: As the proportion of males with Duchenne muscular dystrophy (DMD) surviving into adulthood increases, more information is needed regarding their health care transition planning, an essential process for adolescents and young (...) adults with DMD. The objective of this study was to describe the health care transition experiences of a population of males living with Duchenne or Becker muscular dystrophy (DBMD). Methods: The eligible participants, identified through the Muscular Dystrophy Surveillance Tracking and Research Network (MD STARnet) surveillance project, were 16-31 years old and lived in Arizona, Colorado, Georgia, Iowa, or western New York (n=258). The MD STARnet Health Care Transitions and Other Life Experiences

2018 PLoS currents

13. Measuring care transitions in Sweden: validation of the care transitions measure. Full Text available with Trip Pro

Measuring care transitions in Sweden: validation of the care transitions measure. To translate and assess the validity and reliability of the original American Care Transitions Measure, both the 15-item and the shortened 3-item versions, in a sample of people in transition from hospital to home within Sweden.Translation of survey items, evaluation of psychometric properties.Ten surgical and medical wards at five hospitals in Sweden.Patients discharged from surgical and medical (...) wards.Psychometric properties of the Swedish versions of the 15-item (CTM-15) and the 3-item (CTM-3) Care Transition Measure.We compared the fit of nine models among a sample of 194 Swedish patients. Cronbach's alpha was 0.946 for CTM-15 and 0.74 for CTM-3. The model indices for CTM-15 and CTM-3 were strongly indicative of inferior goodness-of-fit between the hypothesized one-factor model and the sample data. A multidimensional three-factor model revealed a better fit compared with CTM-15 and CTM-3 one factor

2018 International Journal for Quality in Health Care

14. Improving health care transition and longitudinal care for adolescents and young adults with hydrocephalus: report from the Hydrocephalus Association Transition Summit. Full Text available with Trip Pro

Improving health care transition and longitudinal care for adolescents and young adults with hydrocephalus: report from the Hydrocephalus Association Transition Summit. The health care needs of children with hydrocephalus continue beyond childhood and adolescence; however, pediatric hospitals and pediatric neurosurgeons are often unable to provide them care after they become adults. Each year in the US, an estimated 5000-6000 adolescents and young adults (collectively, youth) with hydrocephalus (...) must move to the adult health care system, a process known as health care transition (HCT), for which many are not prepared. Many discover that they cannot find neurosurgeons to care for them. A significant gap in health care services exists for young adults with hydrocephalus. To address these issues, the Hydrocephalus Association convened a Transition Summit in Seattle, Washington, February 17-18, 2017.The Hydrocephalus Association surveyed youth and families in focus groups to identify common

2018 Journal of Neurosurgery

15. PharmD Transitions of Care Program (PHARMD-TOC): A Community Pharmacy Transitions of Care Program

PharmD Transitions of Care Program (PHARMD-TOC): A Community Pharmacy Transitions of Care Program PharmD Transitions of Care Program (PHARMD-TOC): A Community Pharmacy Transitions of Care Program - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove (...) one or more studies before adding more. PharmD Transitions of Care Program (PHARMD-TOC): A Community Pharmacy Transitions of Care Program The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. of clinical studies and talk to your health care provider before participating. Read our for details. ClinicalTrials.gov Identifier: NCT03617380 Recruitment Status

2018 Clinical Trials

16. Site of Death, Place of Care, and Health Care Transitions Among US Medicare Beneficiaries, 2000-2015. Full Text available with Trip Pro

Site of Death, Place of Care, and Health Care Transitions Among US Medicare Beneficiaries, 2000-2015. End-of-life care costs are high and decedents often experience poor quality of care. Numerous factors influence changes in site of death, health care transitions, and burdensome patterns of care.To describe changes in site of death and patterns of care among Medicare decedents.Retrospective cohort study among a 20% random sample of 1 361 870 decedents who had Medicare fee-for-service (2000 (...) , 2005, 2009, 2011, and 2015) and a 100% sample of 871 845 decedents who had Medicare Advantage (2011 and 2015) and received care at an acute care hospital, at home or in the community, at a hospice inpatient care unit, or at a nursing home.Secular changes between 2000 and 2015.Medicare administrative data were used to determine site of death, place of care, health care transitions, which are changes in location of care, and burdensome patterns of care. Burdensome patterns of care were based

2018 JAMA

17. UK guideline on transition of adolescent and young persons with chronic digestive diseases from paediatric to adult care

UK guideline on transition of adolescent and young persons with chronic digestive diseases from paediatric to adult care UK guideline on transition of adolescent and young persons with chronic digestive diseases from paediatric to adult care Alenka J Brooks, 1 * Philip J Smith, 2 * Richard Cohen, 3 Paul Collins, 4 Andrew Douds, 5 Valda Forbes, 6 Daniel R Gaya, 7 Brian T Johnston, 8 Patrick J McKiernan, 9 Charles D Murray, 2 Shaji Sebastian, 10 Monica Smith, 11 Lisa Whitley, 12 Lesley Williams (...) January 2017 To cite: Brooks AJ, Smith PJ, Cohen R, et al. Gut Published Online First: [please include Day Month Year] doi:10.1136/gutjnl- 2016-313000 ABSTRACT The risks of poor transition include delayed and inappropriate transfer that can result in disengagement with healthcare. Structured transition care can improve control of chronic digestive diseases and long-term health-related outcomes. These are the ?rst nationally developed guidelines on the transition of adolescent and young persons (AYP

2017 British Society of Gastroenterology

18. Feasibility and preliminary effects of an integrated hospital-to-home transitional care intervention for older adults with stroke and multimorbidity: A study protocol. Full Text available with Trip Pro

Feasibility and preliminary effects of an integrated hospital-to-home transitional care intervention for older adults with stroke and multimorbidity: A study protocol. Stroke is a major life-altering event and the leading cause of death and disability in Canada. Most older adults who have suffered a stroke will return home and require ongoing rehabilitation in the community. Transitioning from hospital to home is reportedly very stressful and challenging, particularly if stroke survivors have (...) multiple chronic conditions. New interventions are needed to improve the quality of transitions from hospital to home for this vulnerable population.The primary objective of this study is to examine the feasibility of implementing a new 6-month transitional care intervention supported by a web-based app. The secondary objective is to explore its preliminary effects.A single arm, pre/post, pragmatic feasibility study of 20-40 participants in Ontario, Canada. Participants will be community-dwelling older

2019 Journal of comorbidity Controlled trial quality: uncertain

19. Pediatric Heart Transplantation: Transitioning to Adult Care (TRANSIT): Feasibility of a Pilot Randomized Controlled Trial. (Abstract)

Pediatric Heart Transplantation: Transitioning to Adult Care (TRANSIT): Feasibility of a Pilot Randomized Controlled Trial. Young-adult heart transplant recipients transferring to adult care are at risk for poor health outcomes. We conducted a pilot randomized controlled trial to determine the feasibility of and to test a transition intervention for young adults who underwent heart transplantation as children and then transferred to adult care.Participants were randomized to the transition (...) intervention (4 months long, focused on heart-transplant knowledge, self-care, self-advocacy, and social support) or usual care. Self-report questionnaires and medical records data were collected at baseline and 3 and 6 months after the initial adult clinic visit. Longitudinal analyses comparing outcomes over time were performed using generalized estimating equations and linear mixed models.Transfer to adult care was successful and feasible (ie, excellent participation rates). The average patient standard

2019 Journal of cardiac failure Controlled trial quality: uncertain

20. Palliative care transitions from acute care to community-based care - a systematic review. (Abstract)

Palliative care transitions from acute care to community-based care - a systematic review. Although the literature on transitions from hospital to the community is extensive, little is known about this experience within the context of palliative care (PC).We conducted a systematic review to investigate the impact of receiving palliative care in hospital on the transition from hospital to the community.We systematically searched MEDLINE, Embase, ProQuest and CINAHL from 1995 until April 10, 2018 (...) , and extracted relevant references. Eligible articles were published in English, included adult patients receiving PC as inpatients and explored transitions from hospital to the community.1514 studies were identified and 8 met inclusion criteria. Studies were published recently (>2012; n=7, 88%). Specialist PC interventions were delivered by multi-disciplinary care teams as part of inpatient PC triggers, discharge planning programs, and transitional care programs. Common outcomes reported with significant

2019 Journal of pain and symptom management

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