TY - JOUR
T1 - Transitional Care Partners
T2 - a hospital-to-home support for older adults and their caregivers
AU - Hendrix, Cristina
AU - Tepfer, Sara
AU - Forest, Sabrina
AU - Ziegler, Karen
AU - Fox, Valerie
AU - Stein, Jeannette
AU - McConnell, Eleanor S.
AU - Hastings, Susan N.icole
AU - Schmader, Kenneth
AU - Colon-Emeric, Cathleen
PY - 2013/8/1
Y1 - 2013/8/1
N2 - PURPOSE: To describe the development, implementation, and preliminary results of the Transitional Care (TLC) Partners, a clinical demonstration program that supports the transition from hospital to home of older veterans.DATA SOURCES: Hospital records of TLC patients to track their hospital and emergency department visits before and after the TLC Partners enrollment. Caregivers of patients completed Preparedness in Caregiving and the Short Form Zarit Burden Scale during the first week of the TLC Partners enrollment and on the week when the services ended.CONCLUSIONS: The proportion of patients with one or more emergency department visits and rehospitalization is consistently lower among TLC patients compared to non-TLC patients at 30 and 60 days of hospital discharge. The mean preparedness and burden scores before and after the program essentially remained the same.IMPLICATIONS FOR PRACTICE: The description of the implementation of the TLC Partners offers an example of how nurse practitioner-led interprofessional care models can be adapted to the needs of specific healthcare systems, and how they can be monitored to evaluate their reach, effectiveness, and fidelity to the core components of proved care models.
AB - PURPOSE: To describe the development, implementation, and preliminary results of the Transitional Care (TLC) Partners, a clinical demonstration program that supports the transition from hospital to home of older veterans.DATA SOURCES: Hospital records of TLC patients to track their hospital and emergency department visits before and after the TLC Partners enrollment. Caregivers of patients completed Preparedness in Caregiving and the Short Form Zarit Burden Scale during the first week of the TLC Partners enrollment and on the week when the services ended.CONCLUSIONS: The proportion of patients with one or more emergency department visits and rehospitalization is consistently lower among TLC patients compared to non-TLC patients at 30 and 60 days of hospital discharge. The mean preparedness and burden scores before and after the program essentially remained the same.IMPLICATIONS FOR PRACTICE: The description of the implementation of the TLC Partners offers an example of how nurse practitioner-led interprofessional care models can be adapted to the needs of specific healthcare systems, and how they can be monitored to evaluate their reach, effectiveness, and fidelity to the core components of proved care models.
KW - Geriatric
KW - caregiver
KW - home care
KW - nurse practitioners
KW - transitional care model
KW - veterans' health
UR - http://www.scopus.com/inward/record.url?scp=84927173678&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84927173678&partnerID=8YFLogxK
U2 - 10.1111/j.1745-7599.2012.00803.x
DO - 10.1111/j.1745-7599.2012.00803.x
M3 - Article
C2 - 24170636
AN - SCOPUS:84927173678
VL - 25
SP - 407
EP - 414
JO - Journal of the American Association of Nurse Practitioners
JF - Journal of the American Association of Nurse Practitioners
SN - 2327-6886
IS - 8
ER -