Bmc Health Serv Res
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Bmc Health Serv Res · Jan 2013
Randomized Controlled TrialFacilitated patient experience feedback can improve nursing care: a pilot study for a phase III cluster randomised controlled trial.
England's extensive NHS patient survey programme has not fulfilled government promises of widespread improvements in patients' experiences, and media reports of poor nursing care in NHS hospitals are increasingly common. Impediments to the surveys' impact on the quality of nursing care may include: the fact that they are not ward-specific, so nurses claim "that doesn't happen on my ward"; nurses' scepticism about the relevance of patient feedback to their practice; and lack of prompt communication of results. The surveys' impact could be increased by: conducting ward-specific surveys; returning results to ward staff more quickly; including patients' written comments in reports; and offering nurses an opportunity to discuss the feedback. Very few randomised trials have been conducted to test the effectiveness of patient feedback on quality improvement and there have been few, if any, published trials of ward-specific patient surveys. ⋯ This study provides preliminary evidence that facilitated patient feedback can improve patients' experiences such that a full trial is justified. These findings suggest that merely informing nurses of patient survey results in writing does not stimulate improvements, even if results are disaggregated by ward, but the addition of ward meetings had an important and significant impact.
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Bmc Health Serv Res · Jan 2013
Local co-ordination and case management can enhance Indigenous eye care--a qualitative study.
Indigenous adults suffer six times more blindness than other Australians but 94% of this vision loss is unnecessary being preventable or treatable. We have explored the barriers and solutions to improve Indigenous eye health and proposed significant system changes required to close the gap for Indigenous eye health. This paper aims to identify the local co-ordination and case management requirements necessary to improve eye care for Indigenous Australians. ⋯ Co-ordination is a key to close the gap in eye care for Indigenous Australians. Properly co-ordinated care and support along the patient pathway through case management will save money by preventing dropout of patients who haven't received treatment and a successfully functioning system will encourage more people to enter for care.
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Bmc Health Serv Res · Jan 2013
The caregiving perspective in heart failure: a population based study.
Heart failure (HF) is a frequent condition in the elderly and mortality is high. This study sought to describe the profile of those providing care in the community and their needs. ⋯ Study findings suggest that there is a significant burden placed on caregivers for people with HF over extended periods in the community. There are differences in access to services for these caregivers compared to those dying from other conditions, particularly cancer.
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Bmc Health Serv Res · Jan 2013
Bridging evidence-practice gaps: improving use of medicines in elderly Australian veterans.
The Australian Government Department of Veterans' Affairs (DVA) funds an ongoing health promotion based program to improve use of medicines and related health services, which implements interventions that include audit and feedback in the form of patient-specific feedback generated from administrative claims records. We aimed to determine changes in medicine use as a result of the program. ⋯ The Veterans' MATES program showed positive practice change over time, with interventions increasing use of appropriate medicines where under-use was evident and reduced use of inappropriate medicines when single medicines were targeted. Combinations of messages were less effective, suggesting specific messages focusing on single medicines are required to maximise effect. The program provides a model that could be replicated in other settings.
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Bmc Health Serv Res · Jan 2013
Access to the US Department of Veterans Affairs health system: self-reported barriers to care among returnees of Operations Enduring Freedom and Iraqi Freedom.
The U.S. Department of Veterans Affairs (VA) implemented the Polytrauma System of Care to meet the health care needs of military and veterans with multiple injuries returning from combat operations in Afghanistan and Iraq. Studies are needed to systematically assess barriers to use of comprehensive and exclusive VA healthcare services from the perspective of veterans with polytrauma and with other complex health outcomes following their service in Afghanistan and Iraq. These perspectives can inform policy with regard to the optimal delivery of care to returning veterans. ⋯ This study provides an initial description of utilization of VA polytrauma rehabilitation and other medical care for veteran returnees from all military services who were involved in combat operations in Afghanistan or Iraq. Our findings indicate that these veterans reported important stigmatization and barriers to receiving services exclusively from the VA, including mutable health delivery system factors.