Background
Method
Scoping the literature and focusing the review
Searching process and selection of documents
CONCEPTS | KEYWORDS | |
---|---|---|
1 | Population: older adults + [fall-related] | older adult* elder* senior* old* people geriatric patient* older patient* aged[MESH] AND [accidental fall*] [hip fracture*] |
2 | Interventions / follow-up | transition of care / transitional care continuity of patient care discharge planning patient discharge hospital discharge return to home / returning home post discharge + follow up / support |
3 | Outcomes / effects | length of stay in hospital readmission to hospital emergency visit admission to an institution fall mortality functional decline cost health care utilization patient health status patient satisfaction carer satisfaction quality of life well-being |
Selection and appraisal of documents
Data extraction
Analysis and formulation of preliminary program theories
Results
INTERVENTION COMPONENTS (I) | CONTEXTS (C) | MECHANISMS (M) | OUTCOMES (O) |
---|---|---|---|
ICMO-1: Two-way communication between healthcare providers and patients/caregivers | |||
Provide patients and families with individually tailored, complete and repeated information [34] Regarding: information seeking [9] Using: simple language [40] | When Throughout the discharge planning process - frequently [35] Communication on recovery time and risk management For whom - living alone [38] | For patients ↑ understanding of how to balance risks safely [38] For patients and families ↑ adjustment of expectations regarding recovery [41] ↓ confusion and tension between family members [37] For healthcare providers | |
ICMO-2: Interprofessional communication within and across healthcare settings | |||
Interprofessional communication and information sharing By using/doing: verbal and timely non formal communication [9] | When Between different healthcare settings [39] Where | ↑ knowledge and understanding of healthcare providers regarding patients’ situations, and their own respective roles, tasks and responsibilities [9, 34, 46] ↓ redundancies, overlap, delays, inaccuracies, incompleteness, uncertainties regarding what has been done [34] ↓ losses of information across care settings [39] ↓ anxiety and frustration experienced by healthcare providers [39] ↓ time spent gathering information on patients [9] | ↑ identification of patients at risk of falls [47] |
ICMO-3: Patient/caregiver individually tailored education on fall prevention | |||
Patients’ and caregivers’ education and training should: Provide families with written educational material [48] Caregivers’ education and training should also: | When Reinforced education by follow up phone call post discharge [49] For whom If patients cognitively impaired: caregivers’ education is essential [48] | For patients and caregivers ↑ awareness of fall prevention [37] ↑ recognition of near-falls [49] For patients For caregivers | ↓ negative psychological impacts on caregivers (burden) [37] ↑ safety in the care provided by caregivers at home [36] ↑ continuity for patients in transition from hospital to home [37] |
ICMO-4: Discharge planning coordination | |||
Designation of 1 pivotal healthcare provider (coordinator) to manage discharge planning [35, 38, 39, 50]: Acting as the single regular contact point for patients [35] Coordinating a comprehensive intervention adapted to patients [50] Tools to facilitate coordination: Interdisciplinary worksheet to record all the barriers to a safe return home identified by all the healthcare providers [51] | When Throughout the discharge planning process - from admission to discharge [35, 36, 40, 51] - post-discharge (home) [36] For whom | ↑ stability and consistency through coordinator’s regular contacts with patients, families and professionals [34, 39] ↑ trust [39] ↑ communication and information sharing among healthcare providers and settings [53] ↑ identification and prioritization of patients’ needs [48] ↑ personal engagement from each healthcare provider and families over care [34] | ↑ patients’ quality of life (physical, psychological and social needs met) [48] ↑ patients’ satisfaction [52] |