Programmes to support transitions in community care for children with complex care needs: a scoping review.
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ABSTRACT: Objective
This scoping review aimed to map the range of programmes in the literature to support children and youth with complex care needs and their families during transitions in care in the community.Design
A scoping review of the literature.Context
This review included programmes that supported the transition in care to home and between settings in the community.Data sources
We implemented our strategy to search five databases: (1) PubMed; (2) CINAHL; (3) ERIC; (4) PyscINFO and (5) Social Work Abstracts. The search was last implemented on 29 April 2021.Study selection
Our search results were imported into Covidence Systematic Review Software. First, two reviewers assessed titles and abstracts against our eligibility criteria. Relevant articles were then retrieved in full and reviewed by two reviewers for inclusion. Disagreements were resolved by a third reviewer.Data extraction
Relevant data were extracted related to population, concept, context, methods and key findings pertinent to our review objective.Results
A total of 2482 records were identified. After our two-stage screening process, a total of 27 articles were included for analysis. Articles ranged in the type of transitions being supported and target population. The most common transition reported was the hospital-to-home transition. Intervention components primarily consisted of care coordination using a teams-based approach. The most reported barriers and enablers to implementing these transition care programmes were related to physical opportunities.Limitations
Included articles were limited to English and French.Conclusions
This review identified important gaps within the literature, as well as areas for future consideration to ensure the effective development and implementation of programmes to support children and youth with complex care needs during transitions in care.
SUBMITTER: Breneol S
PROVIDER: S-EPMC9272111 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:IntroductionChildren and youth with complex care needs (CCNs) and their families experience many care transitions over their lifespan and are consequently vulnerable to the discontinuity or gaps in care that can occur during these transitions. Transitional care programmes, broadly defined as one or more intervention(s) or service(s) that aim to improve continuity of care, are increasingly being developed to address transitions in care for children and youth with CCNs. However, this literature has not yet been systematically examined at a comprehensive level. The purpose of this scoping review is to map the range of programmes that support transitions in care for children and youth with CCNs and their families during two phases of their lifespan: (1) up to the age of 19 years (not including their transition to adult healthcare) and (2) when transitioning from paediatric to adult healthcare.Methods and analysisThe Joanna Briggs Institute methodology for scoping reviews (ScR) will be used for the proposed scoping review. ScR are a type of knowledge synthesis that are useful for addressing exploratory research questions that aim to map key concepts and types of evidence on a topic and can be used to organise what is known about the phenomena. A preliminary search of PubMed was conducted in December 2018.Ethics and disseminationEthical approval is not required where this study is a review of the published and publicly reported literature. The research team's advisory council will develop a research dissemination strategy with goals, target audiences, expertise/leadership, resources and deadlines to maximise project outputs. The end-of-grant activities will be used to raise awareness, promote action and inform future research, policy and practice on this topic.
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Project description:BackgroundAcute-care interventions that identify patients with substance use disorders (SUDs), initiate treatment, and link patients to community-based services, have proliferated in recent years. Yet, much is unknown about the specific strategies being used to support continuity of care from emergency department (ED) or inpatient hospital settings to community-based SUD treatment. In this scoping review, we synthesize the existing literature on patient transition interventions, and form an initial typology of reported strategies.MethodsWe searched Pubmed, Embase, CINAHL and PsychINFO for peer-reviewed articles published between 2000-2021 that studied interventions linking SUD patients from ED or inpatient hospital settings to community-based SUD services. Eligible articles measured at least one post-discharge treatment outcome and included a description of the strategy used to promote linkage to community care. Detailed information was extracted on the components of the transition strategies and a thematic coding process was used to categorize strategies into a typology based on shared characteristics. Facilitators and barriers to transitions of care were synthesized using the Consolidated Framework for Implementation Research.ResultsForty-five articles met inclusion criteria. 62% included ED interventions and 44% inpatient interventions. The majority focused on patients with opioid (71%) followed by alcohol (31%) use disorder. The transition strategies reported across studies were heterogeneous and often not well described. An initial typology of ten transition strategies, including five pre-and five post-discharge transition strategies is proposed. The most common strategy was scheduling an appointment with a community-based treatment provider prior to discharge. A range of facilitators and barriers were described, which can inform efforts to improve hospital-to-community transitions of care.ConclusionsStrategies to support transitions from acute-care to community-based SUD services, although critical for ensuring continuity of care, vary greatly across interventions and are inconsistently measured and described. More research is needed to classify SUD care transition strategies, understand their components, and explore which lead to the best patient outcomes.
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Project description:IntroductionPoor outcomes following the transition from hospital back to community living are common, especially for older adults with complex health and social care needs. Some health care systems now have multiple interprofessional teams (in hospital and community) to support care transitions. These teams will need to be well coordinated to improve care transition outcomes.MethodsWe conducted a scoping review to identify and map peer-reviewed literature on how interprofessional teams are working together to support older adults transitioning from hospital back to the community. We used the six-stage framework developed by Levac and colleagues (2010). Procedures were guided by the Joanna Briggs Institute scoping review guidelines.ResultsOur structured search and screening process resulted in 70 articles, published between 2000 and 2022, from 14 counties. Within these articles, 26 programs were described that used interprofessional teams in both the hospital and community.DiscussionThe qualitative articles suggested that effective teamwork is very important for promoting care transition quality, but the quantitative research did not report on team-related outcomes. Quantitative research has described, but not evaluated, strategies for promoting interprofessional collaboration.ConclusionFuture research should focus on evaluating processes used to promote effective interprofessional teamwork in care transition interventions.
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Project description:IntroductionMillions of people worldwide have complex health and social care needs. Care coordination for these patients is a core dimension of integrated care and a key responsibility for primary healthcare. Registered nurses play a substantial role in care coordination. This review draws on previous theoretical work and provides a synthesis of care coordination interventions as operationalized by nurses for complex patient populations in primary healthcare.MethodologyWe followed Arksey and O'Malley's methodological framework for scoping reviews. We carried out a systematic search across CINAHL, MEDLINE, Scopus and ProQuest. Only empirical studies were included. We performed a thematic analysis using deductive (the American Nurses Association Framework) and inductive approaches. Findings were discussed with a group of experts.ResultsThirty-four articles were included in the synthesis. Overall, nursing care coordination activities were synthesized into three categories: those targeting the patient, family and caregivers; those targeting health and social care teams; and those bringing together patients and professionals. Interpersonal communication and information transfer emerged as cross-cutting activities that support every other activity. Our results also brought to light the nurses' contribution to care coordination efforts for patients with complex needs as well as critical components that should be present in every care coordination intervention for this clientele. These include an increased intensity and frequency of activities, relational continuity of care, and home visits.ConclusionWith the growing complexity of patient's needs, efforts must be directed towards enabling the primary healthcare level to effectively play its substantial role in care coordination. This includes finding primary care employment models that would facilitate multidisciplinary teamwork and the delivery of integrated care, and guarantee the delivery of intensive yet efficient coordinated care.
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Project description:IntroductionA global variation in the pharmacy support personnel training programmes has been observed. The objective of this scoping review is to map out global evidence available on the pharmacy support personnel training programme characteristics, and interface between knowledge, practice and regulatory requirements.Methods and analysisThe scoping review will be undertaken by two independent reviewers. Peer-reviewed journal articles of any study design and grey literature will be included with no publication time limit. All literature published in English focusing on pharmacy support personnel training programmes, entry-level certification requirements, ongoing professional development and apprenticeship will be included. We will search MEDLINE (EBSCOhost), PubMed, CINAHL (EBSCOhost), Web of Science, Academic Search Complete, (EBSCOhost) and Dissertation and Thesis (ProQuest), ProQuest Dissertation and Thesis Global and Google Scholar, and reference list of all included studies. We will also search grey literature from websites of international professional regulatory bodies and associations. All studies that meet the inclusion criteria will be imported into a reference management package (EndNote V.20) that facilitates study selection, screening and de-duplication. Data will be extracted by two independent reviewers using a jointly developed and piloted data charting form. Data items will include skills, knowledge, competencies, admission criteria, content, duration, qualification options, accreditation status, delivery models and approaches. Data extracted from the included studies will be collated, and quantitative results presented using descriptive statistics such as percentages, tables, charts and flow diagrams as appropriate. A narrative account of findings from the literature will be presented following qualitative content analysis of the extracted information using NVivo V.12. Quality appraisal of included studies will not be assessed as the purpose of the scoping review is to give a descriptive global overview of the pharmacy support personnel training programmes, and evidence will also be sourced from grey literature.Ethics and disseminationNo ethical approval is needed for this study as it does not include animals or human participants. The study findings will be disseminated electronically and in print with presentations done at relevant platforms, that is, in peer-reviewed journals, in print and in conferences.RegistrationOpen Science Framework (ofs.i0/r2cdn; registration DOI: https://doi.org/10.17605/OSF.IO/F95MH; internet archive link: https://archive.org/details/osf-registrations-f95mh-v1; registration type: OSF-Standard Pre-Data Collection Registration).
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Project description:Young people with complex support needs frequently experience multiple intersecting forms of disadvantage including experiences of violence, abuse and neglect, housing instability and homelessness, problematic substance use, exclusion from education, and contact with the criminal justice system. Many of these young people have mental health, cognitive disability and/or other health issues that also impact on their lives. These young people need to navigate multiple, diverse, and often difficult transitions between services, adding to the existing chaos in their lives. This article explores the experiences of young people with complex support needs in transition, specifically young people's viewpoints and experiences of supports they receive from paid professionals. This qualitative study used body mapping research methods and in-depth interviews with 38 young people aged 16 to 26 years in three Australian states. Helpful and trusting paid relationships could serve as an anchor to young people during complex transitions and other highly turbulent life periods. These relationships were contingent on a deep and non-judgmental knowing of the young person, contributed constructive outcomes and stability in young people's lives, and for some young people, had 'life-saving' effects. These findings present opportunities and challenges for policymakers and practitioners to balance the tensions between authentic relationship-based work with young people and risk-averse, economically-driven imperatives in contemporary youth service provision.
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Project description:IntroductionSouth Asian countries are ageing and experiencing a rapid increase in proportion of the older population. Income support programmes are of central importance for the older adults as they may help to mitigate the poverty risks associated with ageing and losing the ability to generate income from labour. Evidence related to the income support programmes can help in understanding whether the programmes have been impactful. This scoping review will map the evidence (and gaps) related to income support programmes and create a base to identify the feasibility of future primary research and/or the scope of systematic reviews in the areas where evidence is available.Methods and analysisThe Joanna Briggs Institute scoping review methodology will be followed. Eligibility criteria for the scoping review will be based on the 'PCC' or the 'Population-Concept-Context' concept. Advanced search for the relevant articles will be conducted in MEDLINE (via PubMed), Embase, Scopus, Campbell Collaboration, 3ie International Initiative for Impact Evaluation and Web of Science. Additional resources search will be conducted in important organisational websites. Findings of the scoping review will be summarised using descriptive information (frequencies and percentages) for the available evidence on concept (ie, income support programmes), population characteristics and other study variables.Ethics and disseminationThe review is based on data from available literature, hence an ethical approval is not necessary. With this review, we attempt to provide recommendations to the research community and the policymakers about the currently available evidence and the research required for income support of older adults in South Asia, so that resources can be directed towards addressing the same. We plan to disseminate the findings through presentation in international conference and publication in a peer-reviewed journal.Review registrationNot registered.
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