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Filter by:This is a single-center pilot study examining the feasibility and acceptability of a transitional rehabilitation intervention, PICTURE-THIS, among critical illness survivors and their families. The intervention activities include transitional care coordination and activity-based rehabilitation delivered by a specialist team and integrated into usual care. There are three components to the assessment of feasibility and acceptability in this study: 1. User testing the PICTURE-THIS protocol to work out basic challenges to feasibility and acceptability. 2. Assessing the feasibility and acceptability of the user-tested PICTURE-THIS protocol. 3. Assessing the feasibility and acceptability of research activities required to test the clinical efficacy of PICTURE-THIS to improve outcomes among critical illness survivors and their family caregivers.
This study evaluates the Community for Successful Ageing (ComSA) Patient-Centered Medical Home (PCMH), a model of community-based primary care geriatric hub at Whampoa, Singapore.
Objectives: The aim of this study is to evaluate the quality of training of the Resources Allocation Exercise (RAE) training programme for higher trainees (HT) and service doctors (SD) in the Hospital Authority (HA) using an evidence-based structured and comprehensive evaluation framework to identify areas for quality enhancement. Design, Setting and Subjects: A longitudinal study will be conducted using the Action Learning and Audit Spiral methodologies to measure whether the target standard of training intended by the RAE training programme is achieved. Each cluster coordinator will be invited to complete a questionnaire on structure and process of training. All eligible HT and SD will be invited to complete a questionnaire on the process of training and their training and education background. All HT and SD will also be included in the evaluation on the outcomes of training programme. Main Outcome Measures: The primary outcomes are the proportion of clusters that have satisfied each of the structure criteria, HT and SD who have reported the criterion process of training, and HT and SD who have rated the training programmes to be of educational value. Data Analysis: Descriptive statistics on standard of training will be calculated. Regressions will be used to identify factors that are associated with quality of training. Hypothesis: The quality of training of the RAE training programme will be determined. Areas of deficiency and possible areas for quality enhancement will be identified. The results of this study will provide empirical evidence on the quality of RAE training programme for HT and SD. It also provides information on the effectiveness of RAE training programmes for improving skills and knowledge of primary care doctors.
This is a prospective randomized wait-list control study to determine whether a stand-alone, co-located team of physician, mental health behaviorist, and care coordinators with decreased panel size (aka "intensive primary care") will reduce inpatient and emergency care utilization, inpatient costs of care, and improve patient activation and experience for medically and socially complex patients, compared to enhanced usual care at 6 and 12 months. Participants with multiple co-morbidities, and meet utilization criteria will have the opportunity to enroll; half the participants will start the intervention immediately, while half will continue enhanced usual care for 6 months before beginning the intervention.
When considered from a provincial perspective, quantification of surgical procedures undertaken by different hospitals and healthcare networks is necessary for informing resource allocation and modelling of healthcare services. The investigators hypothesized that i) non-physiologically complex surgical procedures would account for most (>1/2) of pediatric surgical procedures performed at both pediatric specialist hospitals and the other hospitals performing pediatric surgery, ii) surgical discharges for non-physiologically complex surgical procedures would account for most (>1/2) in-hospital bed nights among pediatric surgical admissions at both pediatric specialist hospitals and the other hospitals performing pediatric surgery, and iii) the relative distributions of non-physiologically complex surgical procedures, but not physiologically complex procedures, would be at least moderately similar between pediatric specialist hospitals and the other hospitals performing pediatric surgery. To test these 3 hypotheses, the specific objectives of this study were to estimate i) the proportion (primary outcome) of non-physiologically complex pediatric surgical procedures, and ii) the similarity and diversity (secondary outcomes) of non-physiologically and physiologically complex surgical procedures between the pediatric specialist hospitals and the other hospitals performing pediatric surgery in Ontario, Canada.
The project objective is to evaluate the impact of the recent addition of pharmacists within family medicine groups (FMGs) on organizational and clinical parameters. The process by which changes occur and the level of pharmacists' activities will also be assessed. The ultimate goal of the project is the development of an accompanying guide to facilitate the work of the pharmacist in monitoring complex patients in primary care medical clinics.
Post Stroke Depression (PSD)is a high volume condition with negative impact on patient recovery after stroke. The primary aim of this study is to evaluate the effectiveness of a system intervention to improve the proportion of Veterans screened and started on treatment for PSD. The secondary aim is evaluate whether a patient-based self-management intervention provides any additional benefit compared to usual care.