A Novel Collaborative Care Program to Augment Nursing Home Care During and After the COVID-19 Pandemic.

COVID-19 Humans Long-Term Care Nursing Homes Pandemics SARS-CoV-2
Nursing homes implementation models of care quality improvement

Journal

Journal of the American Medical Directors Association
ISSN: 1538-9375
Titre abrégé: J Am Med Dir Assoc
Pays: United States
ID NLM: 100893243

Informations de publication

Date de publication:
02 2022
Historique:
received: 15 09 2021
revised: 17 11 2021
accepted: 18 11 2021
pubmed: 20 12 2021
medline: 11 2 2022
entrez: 19 12 2021
Statut: ppublish

Résumé

The 2019 novel coronavirus (COVID-19) pandemic created an immediate need to enhance current efforts to reduce transfers of nursing home (NH) residents to acute care. Long-Term Care Plus (LTC+), a collaborative care program developed and implemented during the COVID-19 pandemic, aimed to enhance care in the NH setting while also decreasing unnecessary acute care transfers. Using a hub-and-spoke model, LTC+ was implemented in 6 hospitals serving as central hubs to 54 geographically associated NHs with 9574 beds in Toronto, Canada. LTC+ provided NHs with the following: (1) virtual general internal medicine (GIM) consultations; (2) nursing navigator support; (3) rapid access to laboratory and diagnostic imaging services; and (4) educational resources. From April 2020 to June 2021, LTC+ provided 381 GIM consultations that addressed abnormal bloodwork (15%), cardiac problems (13%), and unexplained fever (11%) as the most common reasons for consultation. Sixty-five nurse navigator calls addressed requests for non-GIM specialist consultations (34%), wound care assessments (14%), and system navigation (12%). One hundred seventy-seven (46%, 95% CI 41%-52%) consults addressed care concerns sufficiently to avoid the need for acute care transfer. All 36 primary care physicians who consulted the LTC+ program reported strong satisfaction with the advice provided. Early results demonstrate the feasibility and acceptability of an integrated care model that enhances care delivery for NH residents where they reside and has the potential to positively impact the long-term care sector by ensuring equitable and timely access to care for people living in NHs. It represents an important step toward health system integration that values the expertise within the long-term care sector.

Identifiants

DOI: 10.1016/j.jamda.2021.11.018 PMID: 34922907 PMC: PMC8610963
pubmed: 34922907
pii: S1525-8610(21)00988-9
doi: 10.1016/j.jamda.2021.11.018
pmc: PMC8610963
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

304-307.e3

Informations de copyright

Copyright © 2021 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Auteurs

Brian M Wong (BM)

Centre for Quality Improvement and Patient Safety, University of Toronto, Toronto, Ontario, Canada; Division of General Internal Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.

Leahora Rotteau (L)

Centre for Quality Improvement and Patient Safety, University of Toronto, Toronto, Ontario, Canada. Electronic address: leahora.rotteau@mail.utoronto.ca.

Sid Feldman (S)

Baycrest Health Sciences Centre, Toronto, Ontario, Canada; Department of Family and Community Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.

Michael Lamb (M)

Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Division of General Internal Medicine, North York General Hospital, North York, Ontario, Canada.

Kyle Liang (K)

Womens College Hospital Institute for Health System Solutions and Virtual Care, Toronto, Ontario, Canada.

Andrea Moser (A)

Department of Family and Community Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Sienna Senior Living Canada, Markham, Ontario, Canada.

Geetha Mukerji (G)

Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Womens College Hospital Institute for Health System Solutions and Virtual Care, Toronto, Ontario, Canada; Women's College Hospital, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.

Pauline Pariser (P)

Department of Family and Community Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.

Laura Pus (L)

Womens College Hospital Institute for Health System Solutions and Virtual Care, Toronto, Ontario, Canada.

Fahad Razak (F)

Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Division of General Internal Medicine and Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health, Toronto, Ontario, Canada.

Kaveh G Shojania (KG)

Centre for Quality Improvement and Patient Safety, University of Toronto, Toronto, Ontario, Canada; Division of General Internal Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.

Amol Verma (A)

Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Division of General Internal Medicine and Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health, Toronto, Ontario, Canada.

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Classifications MeSH

questionsmedicales.fr › Maladies de l'appareil respiratoire › Infections de l'appareil respiratoire › Pneumopathie infectieuse › Pneumopathie virale › COVID-19 › A Novel Collaborative Care Program to Augment...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › A Novel Collaborative Care Program to Augment...
questionsmedicales.fr › Établissements, main d'oeuvre et services de soins de santé › Services de santé › Soins aux patients › Soins de longue durée › A Novel Collaborative Care Program to Augment...
questionsmedicales.fr › Établissements, main d'oeuvre et services de soins de santé › Établissements de santé › Établissements de soins de long séjour › Maisons de repos › A Novel Collaborative Care Program to Augment...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Épidémies de maladies › Épidémies › Pandémies › A Novel Collaborative Care Program to Augment...
questionsmedicales.fr › Virus › Virus à ARN › Virus à ARN à brin positif › Nidovirales › Coronaviridae › Coronavirus › Betacoronavirus › Virus du SRAS › SARS-CoV-2 › A Novel Collaborative Care Program to Augment...