Optimized Patient Transfer through Innovative Multidisciplinary Assessment: Project Description of Phase I
|Antoinette Conca1*, Rita Bossart1, Katharina Regez1, Ursula Schild1, Gabriela Wallimann1, Ruth Schweingruber1, Virpi Hantikainen2, Petra Tobias1, Werner Albrich1, Kristina Ruegger1, Frank Dusemund1, Ulrich Burgi1, Thomas Sigrist3, Stefan Mariacher-Gehler4, Andreas Huber1, Philipp Schutz1,5, Beat Muller1 and Barbara Reutlinger1|
|1Cantonal Hospital Aarau, Aarau, Switzerland|
|2Institute for Applied Nursing Science, University of Applied Science, St. Gallen, Switzerland|
|3Clinic Barmelweid, Switzerland|
|4AarReha Schinznach, Switzerland|
|5Harvard School of Public Health, Boston, USA|
|Corresponding Author :||Antoinette Conca
Department of Clinical Nursing Science
Cantonal Hospital Aarau AG
Tellstrasse, CH-5001 Aarau, Switzerland
Tel: +4162 8238 4 374
E-mail: [email protected]
|Received: Septmber 14, 2015; Accepted: December 04, 2015; Published: December 12, 2015|
|Citation: Conca A, Bossart R, Regez K, Schild U, Wallimann G, et al. (2015) Optimized Patient Transfer through Innovative Multidisciplinary Assessment: Project Description of Phase I [Translated from the original article in German published in Pflegewissenschaft 2012; 5:291-8]. J Nurs Care 5:316. doi:10.4172/2167-1168.1000316|
|Copyright: © 2015 Conca A, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.|
Introduction: OPTIMA is a multi-professional quality management and research project, conducted at the Cantonal Hospital of Aarau (KSA), Switzerland in cooperation with post-acute care institutions from November 2009 until December 2012.
Objective: The goal of this study was to optimize patient care pathways and to provide patient-centered, costeffective care that is conform with the introduction of the Diagnosis Related Groups (DRG) in 2012.
Methods: The “Post-Acute Care Discharge Scores” (PACD) was applied to assess the risk for transfer to postacute care facilities in 240 patients suffering from lower respiratory tract infections during the first phase of the study (OPTIMA I) from October 2009 until April 2010. In order to assess the patients’ self-care ability, the “Self-Care Index” (SPI) tool was applied on admission and during the course of inpatient treatment.
Results: The PACD predicted that 55% of patients (N=202) were at medium to high risk of requiring post-acute care. According to the SPI, 38% of patients (N=217) showed reduced ability to care for themselves. The discharge of 69% of medically stable patients (N=43) was postponed due to shortage of beds in post-acute care facilities. Correspondingly, 62% of the medically stable patients (N=141) could imagine receiving post-acute care in a “Nurseled Unit” (NLU). Despite being medically stable, one third of the patients (N=124) was not ready to return to their homes because they felt too weak or insecure to cope with everyday life.
Conclusion: Using standardized tools to predict patients at risk for transfer to post-acute care facilities and reduced self-care abilities and the continuous evaluation of medical stability are all methods that could be applied to enhance interdisciplinary care and optimize discharge management. Furthermore, setting up NLU is expected to unburden the occupancy of acute care beds by a considerable amount of patients who are in need of post-acute care.