Improving transitional care improves outcomes important to patients in the 'real world'
Special PCORI supplement to Medical Care reports on 'Future Directions in Transitional Care Research'
2021-07-12
(Press-News.org) July 12, 2021 - Transitions between healthcare sites - such as from the hospital to home or to a skilled nursing facility - carry known risks to patient safety. Many programs have attempted to improve continuity of care during transitions, but it remains difficult to establish and compare the benefits of these complex interventions. An update on patient-centered approaches to transitional care research and implementation is presented in a supplement to the August issue of Medical Care, sponsored by the Patient-Centered Outcomes Research Institute (PCORI). Medical Care is published in the Lippincott portfolio by Wolters Kluwer.
Titled Future Directions in Transitional Care Research, the special issue "focus[es] on opportunities and challenges involved in conducting patient-centered clinical comparative effectiveness research in transitional care," according to an introductory editorial by Carly Parry, PhD, MSW, of PCORI and co-authors. The supplement papers present an overview and update on early findings from PCORI's transitional care research portfolio.
Update on research 'toward a more holistic understanding of transitional care'
Recognizing the high risks and increased costs associated with care transitions has led to new research on interventions to enhance communication and continuity of care. However, new evidence has not always translated into meaningful improvement in the outcomes most important to patients. For this reason, in addition to important outcomes like hospital readmission rates, PCORI has supported research on patient-centered outcomes such as quality of life, caregiver burden, and healthcare decision-making.
A particular challenge is comparing results between studies, or identifying the most important aspects of these multi-component interventions. Providing evidence about the comparative effectiveness of interventions to improve decision making is a key goal of PCORI's investment in transitional care. The supplement presents findings from 11 of the 30 PCORI-funded transitional care studies, representing a wide range of health conditions, healthcare settings, patient characteristics, and patient outcomes.
A paper by Sabina B. Gesell, PhD, of Wake Forest School of Medicine and colleagues highlights the findings and implications of the PCORI transitional care portfolio so far. In discussions with researchers from nine studies, the authors identify three key themes:
Delineating the function versus form of transitional care interventions. While "function" refers to the core purposes of the intervention, "form" refers to the strategies and activities needed to carry out its function. It is critical to distinguish functions from forms. A pragmatic approach would allow for "flexible options for delivery while maintaining appropriate fidelity to the intervention."
Evaluating the process supporting implementation and the impact of interventions. Understanding the processes involved in program adaptations - planned and unplanned - is essential to assessing their actual effects, intended or unintended.
Engaging stakeholders in the design and delivery of interventions. A key aspect of the PCORI approach is engaging stakeholders - including patients, healthcare providers, and advocacy groups or policymakers - in the design and delivery of interventions. Partnering with stakeholders is critical for ensuring that appropriate interventions are designed and successfully disseminated, especially interventions that involve system change. Stakeholders can also play a key role in disseminating the research findings to broader audiences.
The introduction includes an overview of PCORI's Transitional Care Evidence to Action Network: a learning community designed to promote collaboration among researchers and stakeholders, and thus to enhance the collective impact of the new research PCORI has funded on patient-centered transitional care interventions.
"The papers in this Special Issue articulate challenges and lessons learned, and identify new directions for measurement, patient and stakeholder engagement, implementation, and methodological approaches that reflect the complexity of transitional care research," Dr. Parry and coauthors conclude. "They also move us toward a more holistic understanding of transitional care that integrates social needs and lifespan developmental transitions into our approaches to improving transitional care."
Click here to read "Implementation of Complex Interventions: Lessons Learned From the Patient-Centered Outcomes Research Institute Transitional Care Portfolio."
DOI: 10.1097/MLR.0000000000001591
Click here to read "Patient-Centered Approaches to Transitional Care Research and Implementation: Overview and Insights From Patient-Centered Outcomes Research Institute's Transitional Care Portfolio."
DOI: 10.1097/MLR.0000000000001593
INFORMATION:
About Medical Care
Rated as one of the top ten journals in health care administration, Medical Care is devoted to all aspects of the administration and delivery of health care. This scholarly journal publishes original, peer-reviewed papers documenting the most current developments in the rapidly changing field of health care. Medical Care provides timely reports on the findings of original investigations into issues related to the research, planning, organization, financing, provision, and evaluation of health services. In addition, numerous special supplementary issues that focus on specialized topics are produced with each volume. Medical Care is the official journal of the Medical Care Section of the American Public Health Association.
About Wolters Kluwer
Wolters Kluwer (WKL) is a global leader in professional information, software solutions, and services for the clinicians, nurses, accountants, lawyers, and tax, finance, audit, risk, compliance, and regulatory sectors. We help our customers make critical decisions every day by providing expert solutions that combine deep domain knowledge with advanced technology and services.
Wolters Kluwer reported 2020 annual revenues of €4.6 billion. The group serves customers in over 180 countries, maintains operations in over 40 countries, and employs approximately 19,200 people worldwide. The company is headquartered in Alphen aan den Rijn, the Netherlands.
Wolters Kluwer provides trusted clinical technology and evidence-based solutions that engage clinicians, patients, researchers and students in effective decision-making and outcomes across healthcare. We support clinical effectiveness, learning and research, clinical surveillance and compliance, as well as data solutions. For more information about our solutions, visit https://www.wolterskluwer.com/en/health and follow us on LinkedIn and Twitter @WKHealth.
For more information, visit http://www.wolterskluwer.com, follow us on Twitter, Facebook, LinkedIn, and YouTube.
[Attachments] See images for this press release:
ELSE PRESS RELEASES FROM THIS DATE:
2021-07-12
North Carolina State University researchers have developed a new technique that can alter plant metabolism. Tested in tobacco plants, the technique showed that it could reduce harmful chemical compounds, including some that are carcinogenic. The findings could be used to improve the health benefits of crops.
"A number of techniques can be used to successfully reduce specific chemical compounds, or alkaloids, in plants such as tobacco, but research has shown that some of these techniques can increase other harmful chemical compounds while reducing the target compound," said De-Yu Xie, professor of plant and microbial biology at NC State and the corresponding author of a paper describing the research. "Our technology ...
2021-07-12
Snowmelt - the surface runoff from melting snow - is an essential water resource for communities and ecosystems. But extreme snow melt, which occurs when snow melts too rapidly over a short amount of time, can be destructive and deadly, causing floods, landslides and dam failures.
To better understand the processes that drive such rapid melting, researchers set out to map extreme snowmelt events over the last 30 years. Their findings are published in a new paper in the Bulletin of the American Meteorological Society.
"When we talk about snowmelt, people want to know the basic numbers, just like the weather, but no one has ever provided anything like that before. It's like if nobody told you the maximum and minimum temperature or record temperature in your city," said study co-author ...
2021-07-12
The transportation sector is the largest contributor to greenhouse gas emissions in the United States, and a lot of attention has been devoted to electric passenger vehicles and their potential to help reduce those emissions.
But with the rise of online shopping and just-in-time shipping, electric delivery fleets have emerged as another opportunity to reduce the transportation sector's environmental impact.
Though EVs represent a small fraction of delivery vehicles today, the number is growing. In 2019, Amazon announced plans to obtain 100,000 electric delivery vehicles. UPS has ordered 10,000 of them and FedEx plans to be fully electric by 2040.
Now, a study from University of Michigan ...
2021-07-12
New Brunswick, NJ--Children and adolescents with multisystem inflammatory syndrome in children (MIS-C) who are treated initially with intravenous immune globulin (IVIG) and glucocorticoids have reduced risk for serious short-term outcomes, including cardiovascular dysfunction, than those who receive an initial treatment of IVIG alone, a new study finds.
MIS-C is a rare but serious--and sometimes fatal--condition associated with COVID-19, in which different body organs or systems become inflamed, including the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal system. It can occur weeks after having COVID-19 and even if the child or caregivers did not know the child had been infected.
The new study, published in the New England Journal of Medicine, analyzed treatment ...
2021-07-12
Taken together, the bacteria, viruses, fungi and other microbes that live in our intestines form the gut microbiome, which plays a key role in the health of people and animals. In new research from the University of Minnesota, University of Notre Dame and Duke University, scientists found that genetics nearly always plays a role in the composition of the gut microbiome of wild baboons.
"In humans, research has shown that family members share a significant portion of microbes in their gut, but it's hard to answer if our microbiome is shaped more by nature, such as those ...
2021-07-12
A team led by researchers at Baylor College of Medicine found that a screening method known as untargeted metabolomics profiling can improve the diagnostic rate for inborn errors of metabolism, a group of rare genetic conditions, by about seven-fold when compared to the traditional metabolic screening approach.
The study, published in JAMA Network Open, shows that untargeted metabolomics identifies many more disorders of greater variety as compared to traditional methods, including disorders for which there was not a clinically available biochemical test. The researchers hope that adoption of metabolomics to screen for inborn errors of metabolism will result in a more rapid, more efficient ...
2021-07-12
The sharp eyes of an eagle, the extraordinary hearing of an owl - to successfully find food, the eyes and ears of birds have adapted optimally to their living conditions. Until now, the sense of smell has played a rather subordinate role. When meadows are freshly mowed, storks often appear there to search for snails and frogs. Researchers at the Max Planck Institute for Animal Behavior in Radolfzell and the Max Planck Institute for Chemistry in Mainz have now studied the birds' behavior and discovered that the storks are attracted by the smell of the mown grass. Only storks that were downwind and could thus perceive the smell reacted to the mowing. The scientists also sprayed a meadow with a spray of green leaf scents released during mowing. Storks appeared here as well. This ...
2021-07-12
Recall a phone number or directions just recited and your brain will be actively communicating across many regions. It is thought that working memory relies on interactions between these regions, but how these brain areas interact and properly represent memory has remained a mystery.
At Baylor College of Medicine, Dr. Nuo Li, assistant professor of neuroscience and a McNair Scholar, and his colleagues investigated the nature of the communication between brain regions involved in working memory and found evidence that a modular network organization is critical for ...
2021-07-12
The function of a protein can depend on its abundance in a cell. So, when investigating the properties of a new protein, it is essential to make sure that the same amount is produced by every cell. Researchers at Baylor College of Medicine and Rice University have found a new way to do just that through the creation of new genetic circuits called Equalizers.
The findings, in the current edition of Nature Communications, show how researchers engineered these genetic circuits to buffer protein output from variations in the number of copies of the gene inside the cell, thereby helping to create consistent protein expression. This property is called "gene dosage compensation."
The researchers use an analogy of heating ...
2021-07-12
Pure quantum systems can undergo phase transitions analogous to the classical phase transition between the liquid and gaseous states of water. At the quantum level, however, the particle spins in states that emerge from phase transitions display collective entangled behavior. This unexpected observation offers a new avenue for the production of materials with topological properties that are useful in spintronics applications and quantum computing.
The discovery was made by an international collaboration led by Julio Larrea, a professor at the University of São ...
LAST 30 PRESS RELEASES:
[Press-News.org] Improving transitional care improves outcomes important to patients in the 'real world'
Special PCORI supplement to Medical Care reports on 'Future Directions in Transitional Care Research'