Evaluation of the Factors that Promote Improved Experience and Better Outcomes of Older Adults in Intermediate Care Setting

Rona Blendell,Omorogieva Ojo

doi:10.3390/j3010004

Abstract

The aim of this article was to identify the main contributing factors to optimising improved experience and better outcomes for older adults participating in intermediate care setting. Background: Intermediate care is an integrated team intervention for patients experiencing an acute change in their function and well-being. Crisis intervention is one of several intermediate care pathways and provides a timely, person-centred, goal setting assessment to determine appropriate care and support for patients in the community. Method: This systematic review was conducted using key search terms and Boolean operators. A Critical Appraisal Skills Programme (CASP) tool was used to evaluate the studies and the data was extracted and synthesised systematically to develop themes relating to the research question. Results: Seven qualitative primary research studies and one mixed methods study were identified. The main themes were ‘communicating with patients’ and ‘patient participation’. Results showed neither themes are parallel entities but co-dependent. Patient-centred approaches to communication by professionals encouraged active patient participation, in turn optimising patient outcomes. Conclusion: This review showed that patient participation in intermediate care requires professionals using advanced communication skills and taking time to actively listen to what is important to the patients. In addition, poor professional communication resulted in passive patient participation. Implications for future practice are discussed.

Highlights

The reablement intermediate care services are home-based services, but these are provided by multidisciplinary teams who are mostly social care professionals with interventions lasting up to six weeks [4,5]
This was a systematic review which was conducted based on the PICO (Patient/problem—Older Adults; Intervention/exposure—Intermediate care; Comparison—Other clinical settings; Outcome—experiences and perceptions of users and healthcare professionals in intermediate care) model [16] and the Preferred
Seven of the articles were based on qualitative research design and one article was of mixed methods

Summary

Introduction

Intermediate care is a bed-based or home-based integrated service which is aimed at promoting recovery from illness, preventing unnecessary acute admissions to hospital and untimely admissions to long-term care, aiding timely discharge from hospital and maximising independent living [1,2].In recognition of this, the National Service Framework (NSF) for older people in the UK [3] outlined eight national standards which aimed to reduce age discrimination and access to services, promote person centred care, and commission integrated services whilst treating people with respect and dignity according to individual needs.The National Audit of Intermediate Care in England [4] outlined four service models to define intermediate care, including; bed-based intermediate care, home-based intermediate care, crisis response and reablement. Intermediate care is a bed-based or home-based integrated service which is aimed at promoting recovery from illness, preventing unnecessary acute admissions to hospital and untimely admissions to long-term care, aiding timely discharge from hospital and maximising independent living [1,2]. The crisis response category is a community-based service which has a standard response time of four hours and an intervention period lasting up to 48 h, while bed-based services are provided in acute and community settings with up to a six week intervention period [4]. The reablement intermediate care services are home-based services, but these are provided by multidisciplinary teams who are mostly social care professionals with interventions lasting up to six weeks [4,5]. Rabiee and Glendinning [7] see reablement as a social care service which supports people to relearn practical skills and increase confidence by removing environmental barriers

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Discussion

Conclusion