Search results for ‘Subject term:"intermediate care"’ Sort:
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A national evaluation of the costs and outcomes of intermediate care for older people
- Authors:
- BARTON Pelham, et al
- Publisher:
- University of Leicester. Leicester Nuffield Research Unit
- Publication year:
- 2006
- Pagination:
- 167p., bibliog.
- Place of publication:
- Leicester
A national evaluation of the costs and outcomes of intermediate care for older people. Intermediate care is a key government priority, with £900 million announced in the NHS Plan. This three year evaluation from the Universities of Birmingham, Leicester and Sheffield focuses on the factors that help and hinder the development of intermediate care, on progress to date, and on the costs and outcomes associated with different types of intermediate care. The evaluation, which was funded from the Policy Research Programme and the MRC, seeks to establish the range, spread and speed of development of intermediate care services nationally, and to explore commissioners’, practitioners’ and service users’ views and experiences of intermediate care. HSMC’s contribution to the evaluation has centred upon two main areas: Colleagues within the Health Economics Facility (HEF) have explored the costs of intermediate care schemes in relation to their outcomes and synthesised evidence on the costs and outcomes of different models of intermediate care and on best practice; HSMC colleagues have carried out research in several case-study sites in order to explore the development of intermediate care in depth, including those factors which facilitate and constrain progress.
Diversity in intermediate care
- Authors:
- MARTIN Graham Paul, et al
- Journal article citation:
- Health and Social Care in the Community, 12(2), March 2004, pp.150-154.
- Publisher:
- Wiley
Discusses the evolution of intermediate care (IC) and presents interim observations from a survey of providers in England being conducted as part of a national evaluation. Telephone interviews covering various issues concerning level of provision and style of delivery have been conducted with 70 services. Data are used to discuss the progress, range and nature of IC in relation to clinician viewpoints and academic and official literature on the subject. IC 'on the ground' is a multiplicitous entity, with provision apparently evolving in accordance with the particularities of local need. While protocols for medical involvement in IC generally appear to be well established, there are some tensions concerning integration of services in a locality, care management processes and questions of flexibility and inclusiveness in relation to eligibility criteria.
Intermediate care: from innovation to post-mortem?
- Author:
- WILSON Keith
- Journal article citation:
- Journal of Integrated Care, 11(6), December 2003, pp.4-6.
- Publisher:
- Emerald
Presents a critical overview of the creation and implementation of the national policy for intermediate care.
The evaporation effect: final evaluation of the Help the Aged intermediate care programme for older people
- Authors:
- CORNES Michelle, WEINSTEIN Pauline, MANTHORPE Jill
- Publisher:
- Help the Aged
- Publication year:
- 2006
- Pagination:
- 47p.
- Place of publication:
- London
This is the final evaluation of the Help the Aged Intermediate Care Programme for Older People, drawing attention to the hardship caused by the 'evaporation' of intermediate care after a matter of weeks, when the need is clearly for continuing care.
An evaluation of intermediate care for older people: final report
- Authors:
- GODFREY Mary, et al
- Publisher:
- University of Leeds. Institute of Health Sciences and Public Health Research
- Publication year:
- 2005
- Pagination:
- 533p., bibliog.
- Place of publication:
- Leeds
This project forms part of the national evaluation of intermediate care services in England commissioned by the Department of Health. Information on the National Intermediate Care Evaluation Project (NICEP) and the work being carried out by the other two research teams at Leicester / Birmingham Universities and the Bradford Hospital NHS Trust with Bradford and York Universities. This study examined the structure, content, outcomes and costs of intermediate care. The research questions guiding the study were: What is intermediate care? What are its effects and outcomes?.
Show me the way to go home: briefing paper
- Author:
- OXFORD BROOKES UNIVERSITY. Institute of Public Care
- Publisher:
- Oxford Brookes University. Institute of Public Care
- Publication year:
- 2022
- Pagination:
- 7
- Place of publication:
- Oxford
This paper reflects on the findings from a national evaluation of implementation of Discharge to Assess (D2A) carried out by the Institute of Public Care (IPC) with colleagues at RSM; and identifies the factors likely to be associated with greater success. The research team worked with a range of 10 health and care systems throughout England, and concluded that the policy and guidance gave a clear mandate and was a catalyst for local development and implementation. We found that the most important factors influencing the success of D2A include: intelligent market-shaping and commissioning strategies ensure there are sufficient and appropriate community-based services commissioned or provided to meet demands, including low level support from the voluntary and community sector (and ensuring that people don't default to bedded provision for lack of these services); there is a focus in all Intermediate Care services, including bedded services, on getting people back home after a short-term episode of care, and these services do not lead inexorably to permanent residential admissions; the weekly demands on both community-based services and bedded services are understood and the flow of patients through these services is well managed (there should not be delays waiting for the next longer-term services); and the performance measures used to monitor the service adequately capture the above activity as well as individual and aggregated outcomes. (Edited publisher abstract)
Implementing an integrated acute response service: professional perceptions of intermediate care
- Authors:
- MACINNES Julie, et al
- Journal article citation:
- Journal of Integrated Care, 29(1), 2021, pp.48-60.
- Publisher:
- Emerald
Purpose: The purpose of this study is to examine the implementation, care processes and sustainability of an integrated, intermediate Acute Response Team (ART) service. The primary aims of the service are to enhance the level of health and social care integration across a range of organisations, to ensure a timelier and appropriate service for people in the community at risk of admission to hospital. Design/methodology/approach: A qualitative methodology was employed in order to gain a deep understanding of the experiences of staff members within the ART service and external stakeholders. Twenty-one professionals took part in a focus group or one-to-one interviews. Data were analysed thematically. Findings: The key to successful implementation was that the service was co-created from the “ground-up” with support from local provider organisations. The inclusion of general practitioners (GPs) as part of the team was instrumental in setting up and maintaining the service and seems to be unique in intermediate care settings. Referrals into the ART service were dependent on awareness of the service at the interface with mainstream services. Transitions out were sometimes delayed due lack of availability of social care packages. To ensure sustainability of the ART and other integrated intermediate care services, continued resources, especially skilled staff members, are necessary. Originality/value: This study adds to the intermediate care and acute response service literature by offering insights into “what works” from a professional perspective in terms of service implementation, care processes and sustainability, in an integrated care system. (Edited publisher abstract)
Hospital-at-home Integrated Care Programme for the management of disabling health crises in older patients: comparison with bed-based Intermediate Care
- Authors:
- MAS Miquel A., et al
- Journal article citation:
- Age and Ageing, 46(6), 2017, pp.925-931.
- Publisher:
- Oxford University Press
Objective: To analyse the clinical impact of a home-based Intermediate Care model in the Catalan health system, comparing it with usual bed-based care. Design: Quasi-experimental longitudinal study. Setting: Hospital Municipal de Badalona and El Carme Intermediate Care Hospital, Badalona, Catalonia, Spain. Participants: Older patients with medical and orthopaedic disabling health crises in need of Comprehensive Geriatric Assessment (CGA) and rehabilitation. Methods: A CGA-based hospital-at-home Integrated Care Programme (acute care and rehabilitation) was compared with a propensity score matched cohort of contemporary patients attended by usual inpatient hospital care (acute care plus intermediate care hospitalisation), for the management of medical and orthopaedics processes. Main outcomes measures were: (a) Health crisis resolution (referral to primary care at the end of the intervention); (b) functional resolution: relative functional gain and (c) favourable crisis resolution (health + functional) = a + b. The article compared between-groups outcomes using uni/multivariable logistic regression models. Results: Clinical characteristics were similar between home-based and bed-based groups. Acute stay was shorter in home group: 6.1 (5.3–6.9) versus 11.2 (10.5–11.9) days, P < 0.001. The home-based scheme showed better results on functional resolution and on favourable crisis resolution, with shorter length of intervention, with a reduction of −5.72 (−9.75 and −1.69) days. Conclusions: In the study, the extended CGA-based hospital-at-home programme was associated with shorter stay and favourable clinical outcomes. Future studies might test this intervention to the whole Catalan integrated care system. (Edited publisher abstract)
Qualitative evaluation of the implementation of the Interdisciplinary Management Tool: a reflective tool to enhance interdisciplinary teamwork using Structured, Facilitated Action Research for Implementation
- Authors:
- NANCARROW Susan A., et al
- Journal article citation:
- Health and Social Care in the Community, 23(4), 2015, pp.437-448.
- Publisher:
- Wiley
Reflective practice is used increasingly to enhance team functioning and service effectiveness; however, there is little evidence of its use in interdisciplinary teams. This paper presents the qualitative evaluation of the Interdisciplinary Management Tool (IMT), an evidence-based change tool designed to enhance interdisciplinary teamwork through structured team reflection. The IMT incorporates three components: an evidence-based resource guide; a reflective implementation framework based on Structured, Facilitated Action Research for Implementation methodology; and formative and summative evaluation components. The IMT was implemented with intermediate care teams supported by independent facilitators in England. Each intervention lasted 6 months and was evaluated over a 12-month period. Data sources include interviews, a focus group with facilitators, questionnaires completed by team members and documentary feedback from structured team reports. Data were analysed qualitatively using the Framework approach. The IMT was implemented with 10 teams, including 253 staff from more than 10 different disciplines. Team challenges included lack of clear vision; communication issues; limited career progression opportunities; inefficient resource use; need for role clarity and service development. The IMT successfully engaged staff in the change process, and resulted in teams developing creative strategies to address the issues identified. Participants valued dedicated time to focus on the processes of team functioning; however, some were uncomfortable with a focus on teamwork at the expense of delivering direct patient care. The IMT is a relatively low-cost, structured, reflective way to enhance team function. It empowers individuals to understand and value their own, and others' roles and responsibilities within the team; identify barriers to effective teamwork, and develop and implement appropriate solutions to these. To be successful, teams need protected time to take for reflection, and executive support to be able to broker changes that are beyond the scope of the team. (Publisher abstract)
The home-visiting process for older people in the in-patient intermediate care services
- Author:
- HIBBERD Jane
- Journal article citation:
- Quality in Ageing, 9(1), March 2008, pp.13-23.
- Publisher:
- Pier Professional
- Place of publication:
- Brighton
Within the current constraints on health and social care services, it is essential that interventions such as home visits for older people can be seen to be appropriately deployed resources for facilitating their safe and timely discharge home. This paper discusses the findings of an evaluation project undertaken in 2003/04 with two in-patient intermediate care services. The service provided a short-term intervention for older people, with an emphasis on rehabilitation to enable a safe return to their own home environment.