Introduction of a novel service model to improve uptake and adherence with cardiac rehabilitation within Buckinghamshire Healthcare NHS Trust.
Introduction of a novel service model to improve uptake and adherence with cardiac rehabilitation within Buckinghamshire Healthcare NHS Trust.
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DOI：
10.1186/s12872-017-0606-2
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发表时间：
2017-07-11
影响因子：
2.1
通讯作者：
Clifford P
中科院分区：
文献类型：
--
作者：
McCartan F;Bowers N;Turner J;Mandalia M;Kalnad N;Bishop-Bailey A;Fu J;Clifford P
白金汉郡医疗保健NHS信托基金（BHT）进行了心脏康复（CR）服务的重新设计，旨在优化患者招募和保留，减少再入院。进行了一项单中心观察性研究和当地服务评价，以描述新技术支持的CR模型的影响。收集BHT时转诊CR的成人患者数据，回顾性收集实施前12个月期间转诊的患者数据（队列1），前瞻性收集实施后12个月期间转诊的患者数据（队列2）。观察性研究包括每个队列中的350名患者，季节性匹配;服务评估包括所有符合条件的患者。未进行数据插补。在观察性研究中，队列2（84.3%）中进入CR的转诊患者比例高于队列1（76.0%，P = 0.006）。队列2中在出院后6个月内发生≥1次心脏相关紧急再入院的患者（4.3%）少于队列1（8.9%，P = 0.015）; 30天和12个月内的再入院无显著差异。队列2（35.0天）从出院至进入CR的中位时间显著短于队列1（46.0天，P < 0.001）。队列2（75.6%）的CR完成率显著高于队列1（47.4%，P < 0.001）;队列2（80.0天）完成患者的中位CR持续时间显著长于队列1（49.0天，P < 0.001）。总体而言，在服务评价中观察到类似的结果。新技术支持的CR模型的引入与急诊再入院的短期改善以及CR入组、持续时间和完成率的持续增加相关。
Buckinghamshire Healthcare NHS Trust (BHT) carried out a cardiac rehabilitation (CR) service redesign aimed at optimising patient recruitment and retention and decreasing readmissions. A single centre observational study and local service evaluation were carried out to describe the impact of the novel technology-enabled CR model. Data were collected for adult patients referred for CR at BHT, retrospectively for patients referred during the 12-month pre-implementation period (Cohort 1) and prospectively for patients referred during the 12-month post-implementation period (Cohort 2). The observational study included 350 patients in each cohort, seasonally matched; the service evaluation included all eligible patients. No data imputation was performed. In the observational study, a higher proportion of referred patients entered CR in Cohort 2 (84.3%) than Cohort 1 (76.0%, P = 0.006). Fewer patients in Cohort 2 had ≥1 cardiac-related emergency readmission within 6 months of discharge (4.3%) than Cohort 1 (8.9%, P = 0.015); readmissions within 30 days and 12 months were not significantly different. Median time to CR entry from discharge was significantly shorter in Cohort 2 (35.0 days) than Cohort 1 (46.0 days, P < 0.001). The CR completion rate was significantly higher in Cohort 2 (75.6%) than Cohort 1 (47.4%, P < 0.001); median CR duration for completing patients was significantly longer in Cohort 2 (80.0 days) than Cohort 1 (49.0 days, P < 0.001). Overall, similar results were observed in the service evaluation. Introduction of the novel technology-enabled CR model was associated with short-term improvements in emergency readmissions and sustained increases in CR entry, duration and completion.
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DOI：
10.1136/bmj.h5000
发表时间：
2015-09-29
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Dalal HM;Doherty P;Taylor RS
通讯作者：
Taylor RS
影响因子：
2.7
作者：
Sagar VA;Davies EJ;Briscoe S;Coats AJ;Dalal HM;Lough F;Rees K;Singh S;Taylor RS
通讯作者：
Taylor RS
DOI：
10.1177/1741826710397107
发表时间：
2011-10-01
影响因子：
--
作者：
Clark, Alexander M.;Catto, Sonnda;MacIntyre, Paul D.
通讯作者：
MacIntyre, Paul D.
影响因子：
8.3
作者：
Clark, Robyn A.;Conway, Aaron;Tideman, Phillip
通讯作者：
Tideman, Phillip
影响因子：
2.6
作者：
Dahhan, Ali;Maddox, William R.;Sharma, Gyanendra K.
通讯作者：
Sharma, Gyanendra K.