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Transitional Care Partners: a hospital-to-home support for older adults and their caregivers.

Publication ,  Journal Article
Hendrix, C; Tepfer, S; Forest, S; Ziegler, K; Fox, V; Stein, J; McConnell, ES; Hastings, SN; Schmader, K; Colon-Emeric, C
Published in: J Am Assoc Nurse Pract
August 2013

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.

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Published In

J Am Assoc Nurse Pract

DOI

EISSN

2327-6924

Publication Date

August 2013

Volume

25

Issue

8

Start / End Page

407 / 414

Location

United States

Related Subject Headings

  • Program Evaluation
  • Patient Readmission
  • Patient Discharge
  • Middle Aged
  • Male
  • Humans
  • Hospitals, Veterans
  • Health Services Needs and Demand
  • Female
  • Emergency Service, Hospital
 

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Hendrix, C., Tepfer, S., Forest, S., Ziegler, K., Fox, V., Stein, J., … Colon-Emeric, C. (2013). Transitional Care Partners: a hospital-to-home support for older adults and their caregivers. J Am Assoc Nurse Pract, 25(8), 407–414. https://doi.org/10.1111/j.1745-7599.2012.00803.x
Hendrix, Cristina, Sara Tepfer, Sabrina Forest, Karen Ziegler, Valerie Fox, Jeannette Stein, Eleanor S. McConnell, Susan Nicole Hastings, Kenneth Schmader, and Cathleen Colon-Emeric. “Transitional Care Partners: a hospital-to-home support for older adults and their caregivers.J Am Assoc Nurse Pract 25, no. 8 (August 2013): 407–14. https://doi.org/10.1111/j.1745-7599.2012.00803.x.
Hendrix C, Tepfer S, Forest S, Ziegler K, Fox V, Stein J, et al. Transitional Care Partners: a hospital-to-home support for older adults and their caregivers. J Am Assoc Nurse Pract. 2013 Aug;25(8):407–14.
Hendrix, Cristina, et al. “Transitional Care Partners: a hospital-to-home support for older adults and their caregivers.J Am Assoc Nurse Pract, vol. 25, no. 8, Aug. 2013, pp. 407–14. Pubmed, doi:10.1111/j.1745-7599.2012.00803.x.
Hendrix C, Tepfer S, Forest S, Ziegler K, Fox V, Stein J, McConnell ES, Hastings SN, Schmader K, Colon-Emeric C. Transitional Care Partners: a hospital-to-home support for older adults and their caregivers. J Am Assoc Nurse Pract. 2013 Aug;25(8):407–414.
Journal cover image

Published In

J Am Assoc Nurse Pract

DOI

EISSN

2327-6924

Publication Date

August 2013

Volume

25

Issue

8

Start / End Page

407 / 414

Location

United States

Related Subject Headings

  • Program Evaluation
  • Patient Readmission
  • Patient Discharge
  • Middle Aged
  • Male
  • Humans
  • Hospitals, Veterans
  • Health Services Needs and Demand
  • Female
  • Emergency Service, Hospital