International Journal of Paramedicine, Journal Year: 2023, Volume and Issue: 4, P. 68 - 115
Published: Oct. 12, 2023
Language: Английский
BMC Health Services Research, Journal Year: 2024, Volume and Issue: 24(1)
Published: Feb. 8, 2024
Abstract Background The aim of this systematic review was to examine the relationship between strategies improve care delivery for older adults in ED and evaluation measures patient outcomes, experience, staff system performance. Methods A English language studies published since inception December 2022, available from CINAHL, Embase, Medline, Scopus conducted. Studies were reviewed by pairs independent reviewers included if they met following criteria: participant mean age ≥ 65 years; setting or directly influenced provision ED; reported on improvement interventions strategies; methodological quality assessed using Joanna Briggs Institute critical appraisal tools. Data synthesised a hermeneutic approach. Results Seventy-six review, incorporating comprehensive assessment multi-faceted ( n = 32), targeted such as management falls risk, functional decline, pain 27), medication safety 5), trauma 12). We found misalignment delivered performance oriented rapid referral. Eight (10.4%) experience five (6.5%) experience. Conclusion It is crucial that future align needs with purpose ensure sustainable effort functioning an interdependent component health system. Staff input at design stage may advance prioritisation higher-impact aligned pace change illuminate measures. More consistent reporting would inform important contextual factors allow replication.
Language: Английский
Citations
6
Frontiers in Psychiatry, Journal Year: 2024, Volume and Issue: 15
Published: Feb. 29, 2024
Background Care delivery for the increasing number of people presenting at hospital emergency departments (EDs) with mental illness is a challenging issue. This review aimed to synthesise research evidence associated strategies used improve ED care outcomes, experience, and performance adults illness. Method We systematically reviewed regarding effects ED-based interventions on patient system performance, using comprehensive search strategy designed identify published empirical studies. Systematic searches in Scopus, Ovid Embase, CINAHL, Medline were conducted September 2023 (from inception; protocol was prospectively registered Prospero CRD42023466062). Eligibility criteria as follows: (1) primary study, English; (2) (a) reported an implemented model or change within context, (b) focused adult presentations, (c) evaluated staff experience. Pairs reviewers independently assessed study titles, abstracts, full texts according pre-established inclusion discrepancies resolved by third reviewer. Independent extracted data from included papers Covidence (2023), quality studies Joanna Briggs Institute suite critical appraisal tools. Results A narrative synthesis performed 46 studies, comprising pre-post ( n = 23), quasi-experimental 6), descriptive randomised controlled trial (RCT; 3), cohort 2), cross-sectional qualitative realist evaluation 1), time series analysis 1). Eleven articles presentations related substance use disorder presentation, 9 suicide deliberate self-harm 26 general. Strategies include models (e.g., ED-initiated Medications Opioid Use Disorder, social support, self-harm), decision support tools, discharge transfer refinements, case management, adjustments liaison psychiatry services, telepsychiatry, changes roles rostering, environmental specialised units ED), education, creation multidisciplinary teams, standardisations. System measures 33 (72%), fewer reporting outcomes 19, 41%), experience 10, 22%), 14, 30%). Few across all four domains. Heterogeneity samples, strategies, makes adopting existing challenging. Conclusion complex, particularly setting. provide must align goals
Language: Английский
Citations
6
International Journal of Qualitative Methods, Journal Year: 2024, Volume and Issue: 23
Published: Jan. 1, 2024
Enhancing user and provider experience are central tenets of value-based healthcare. Gaining access to personal distinct experiential knowledge is the first stage an experience-based codesign (EBCD) approach, underpinning second codesigned improvement: itself. This state-of-the-art review synthesised evolving scope nature methods gather reported in EBCD literature. Fifty-three 64 (83%) scholarly articles reviewed were published since 2017. Methods promote inclusivity diverse groups move more rapidly codesign. However, omitted steps methodology undermined fulfilment core principles approach which may diminish its value as accepted form Experiential crucial for designing user-centred health care. The challenge lies making healthcare accessible. provides guidance on key modifications that overcome barriers while upholding meeting objectives inquiry.
Language: Английский
Citations
3
Journal of Racial and Ethnic Health Disparities, Journal Year: 2023, Volume and Issue: unknown
Published: Dec. 20, 2023
The emergency department (ED) is an important gateway into the health system for people from culturally and linguistically diverse (CALD) backgrounds; their experience in ED likely to impact way they access care future. Our review aimed describe interventions used improve delivery adults a CALD background.An electronic search of four databases was conducted identify empirical studies that reported with primary focus improving (aged ≥ 18 years), measures relating performance, patient outcomes, experience, or staff experience. Studies published inception November 2022 were included. We excluded non-empirical studies, where intervention not provided ED, papers full text unavailable, language other than English. strategies categorised thematically, tabulated.Following screening 3654 abstracts, 89 articles underwent review; 16 met inclusion criteria. Four clear targeting action tailored population interest identified: self-management issues, communication between patients providers, adhering good clinical practice, building workforce capacity.The identified provide useful framework targeted outcome interest. These detailed examples show how design must consider intersecting socio-economic barriers, so as perpetuate existing disparity.PROSPERO registration number: CRD42022379584.
Language: Английский
Citations
2
Emergency Medicine Australasia, Journal Year: 2024, Volume and Issue: 36(6), P. 823 - 833
Published: Sept. 24, 2024
Abstract Equitable access means that timely, sensitive and respectful treatment is offered to all people. Adults with disability ED care more frequently than the general population. However, in Australia internationally, people experience poorer healthcare outcomes There acknowledgement environments processes of could be better designed promote equitable access, so as not further disadvantage, disable create vulnerability. This systematic review aimed locate describe evaluated strategies implemented improve for (aged 18–65 years) ED. Four databases were searched from inception June 2024. 1936 peer‐reviewed papers reviewed by pairs independent reviewers. studies met our inclusion criteria, demonstrating limited literature reporting on adults aged years. Three focused needs intellectual disability, one created a specific pathway experiencing status epilepticus. No across patient experience, outcomes, system performance staff evaluation measures. We have referenced helpful resources published elsewhere drawn previous reviews provide guidance development targeted initiatives.
Language: Английский
Citations
0
International Journal of Qualitative Methods, Journal Year: 2024, Volume and Issue: 23
Published: Jan. 1, 2024
Previous reviews of experience-based codesign (EBCD) projects have shown non-participant observations (NPOs) are omitted or unreported in the majority studies, despite academics’ insistence their value. We undertook Stage 1 an EBCD project using a Case Study Research approach to organise inquiry. NPOs were used as first object (frame analysis) case subject, exploring and understanding experience users providers ED care. 162 hours conducted by six research team members across three hospital Emergency Departments (EDs), representing local nested case. The four principles guide inquiry, providing rich description context, valuable insights into critical issues. Summarised NPO narratives allowed familiarise themselves with different physical environments, workflows, processes, well think more deeply about work interactions. Conducted within complex healthcare settings, this example demonstrates value observing Work-As-Done has advanced knowledge institutional logic that will be considering realistic sustainable change initiatives. Commitment intentional design well-reported methods for lived can satisfy academic audiences study integrity provide comprehensive information those undertaking accelerated EBCD.
Language: Английский
Citations
0
International Journal of Paramedicine, Journal Year: 2023, Volume and Issue: 4, P. 68 - 115
Published: Oct. 12, 2023
Language: Английский
Citations
0