The effect of a virtual ward program on emergency services utilization and quality of life in frail elderly patients after discharge: a pilot study
Doris Y P Leung,1 Diana Tze-Fan Lee,1 Iris F K Lee,1 Lai-Wah Lam,1 Susanna W Y Lee,2 May W M Chan,3 Yin-Ming Lam,4 Siu-Hung Leung,5 Pui-Chi Chiu,6 Nelly K F Ho,7 Ming-Fai Ip,8 May My Hui8 1The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, Hong Kong; 2Hospital Authority...
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Dove Medical Press
2015
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oai:doaj.org-article:56cc0fd5ea0e47c5ad68d253ca6611ea2021-12-02T05:14:02ZThe effect of a virtual ward program on emergency services utilization and quality of life in frail elderly patients after discharge: a pilot study1178-1998https://doaj.org/article/56cc0fd5ea0e47c5ad68d253ca6611ea2015-02-01T00:00:00Zhttps://www.dovepress.com/the-effect-of-a-virtual-ward-program-on-emergency-services-utilization-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Doris Y P Leung,1 Diana Tze-Fan Lee,1 Iris F K Lee,1 Lai-Wah Lam,1 Susanna W Y Lee,2 May W M Chan,3 Yin-Ming Lam,4 Siu-Hung Leung,5 Pui-Chi Chiu,6 Nelly K F Ho,7 Ming-Fai Ip,8 May My Hui8 1The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, Hong Kong; 2Hospital Authority Head Office, 3Kowloon West Cluster, 4New Territories West Cluster, 5Kowloon East Cluster, 6United Christian Hospital, 7Kowloon Hospital, 8Tuen Mun Hospital, Hong Kong Hospital Authority, Kowloon, Hong Kong Introduction: Attendance at emergency departments and unplanned hospital readmissions are common for frail older patients after discharge from hospitals. A virtual ward service was piloted to deliver “hospital-at-home” services by community nurses and geriatricians to frail older patients immediately after their discharge from hospital to reduce emergency services utilization.Objectives: This study examined the impacts of the virtual ward service on changes in the patients’ emergency attendance and medical readmissions, and their quality of life (QOL).Methods: A matched-control quasi-experimental study was conducted at four hospitals, with three providing the virtual ward service (intervention) and one providing the usual community nursing care (control). Subjects in the intervention group were those who are at high risk of readmission and who are supported by home carers recruited from the three hospitals providing the virtual ward service. Matched control patients were those recruited from the hospital providing usual care. Outcome measures include emergency attendance and medical readmission in the past 90 days as identified from medical records, and patient-reported QOL as measured by the modified Quality-of-Life Concerns in the End of Life Questionnaire (Chinese version). Wilcoxon signed-rank tests compared the changes in the outcome variables between groups.Results: A total of 39 patients in each of the two groups were recruited. The virtual ward group showed a greater significant reduction in the number of unplanned emergency hospital readmissions (-1.41±1.23 versus -0.77±1.31; P=0.049) and a significant improvement in their overall QOL (n=18; 0.60±0.56 versus 0.07±0.56; P=0.02), but there was no significant difference in the number of emergency attendances (-1.51±1.25 versus -1.08±1.48; P=0.29).Conclusion: The study results support the effectiveness of the virtual ward service in reducing unplanned emergency medical readmissions and in improving the QOL in frail older patients after discharge. Keywords: elderly, emergency attendance, emergency medical readmission, emergency services utilization, quality of life, virtual wardLeung DYPLee DTFLee IFKLam LWLee SWYChan MWMLam YMLeung SHChiu PCHo NKFIp MFHui MMDove Medical PressarticleElderlyemergency attendanceemergency medical readmissionemergency services utilizationquality of lifevirtual wardGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 10, Pp 413-420 (2015) |
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DOAJ |
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DOAJ |
| language |
EN |
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Elderly emergency attendance emergency medical readmission emergency services utilization quality of life virtual ward Geriatrics RC952-954.6 |
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Elderly emergency attendance emergency medical readmission emergency services utilization quality of life virtual ward Geriatrics RC952-954.6 Leung DYP Lee DTF Lee IFK Lam LW Lee SWY Chan MWM Lam YM Leung SH Chiu PC Ho NKF Ip MF Hui MM The effect of a virtual ward program on emergency services utilization and quality of life in frail elderly patients after discharge: a pilot study |
| description |
Doris Y P Leung,1 Diana Tze-Fan Lee,1 Iris F K Lee,1 Lai-Wah Lam,1 Susanna W Y Lee,2 May W M Chan,3 Yin-Ming Lam,4 Siu-Hung Leung,5 Pui-Chi Chiu,6 Nelly K F Ho,7 Ming-Fai Ip,8 May My Hui8 1The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, Hong Kong; 2Hospital Authority Head Office, 3Kowloon West Cluster, 4New Territories West Cluster, 5Kowloon East Cluster, 6United Christian Hospital, 7Kowloon Hospital, 8Tuen Mun Hospital, Hong Kong Hospital Authority, Kowloon, Hong Kong Introduction: Attendance at emergency departments and unplanned hospital readmissions are common for frail older patients after discharge from hospitals. A virtual ward service was piloted to deliver “hospital-at-home” services by community nurses and geriatricians to frail older patients immediately after their discharge from hospital to reduce emergency services utilization.Objectives: This study examined the impacts of the virtual ward service on changes in the patients’ emergency attendance and medical readmissions, and their quality of life (QOL).Methods: A matched-control quasi-experimental study was conducted at four hospitals, with three providing the virtual ward service (intervention) and one providing the usual community nursing care (control). Subjects in the intervention group were those who are at high risk of readmission and who are supported by home carers recruited from the three hospitals providing the virtual ward service. Matched control patients were those recruited from the hospital providing usual care. Outcome measures include emergency attendance and medical readmission in the past 90 days as identified from medical records, and patient-reported QOL as measured by the modified Quality-of-Life Concerns in the End of Life Questionnaire (Chinese version). Wilcoxon signed-rank tests compared the changes in the outcome variables between groups.Results: A total of 39 patients in each of the two groups were recruited. The virtual ward group showed a greater significant reduction in the number of unplanned emergency hospital readmissions (-1.41±1.23 versus -0.77±1.31; P=0.049) and a significant improvement in their overall QOL (n=18; 0.60±0.56 versus 0.07±0.56; P=0.02), but there was no significant difference in the number of emergency attendances (-1.51±1.25 versus -1.08±1.48; P=0.29).Conclusion: The study results support the effectiveness of the virtual ward service in reducing unplanned emergency medical readmissions and in improving the QOL in frail older patients after discharge. Keywords: elderly, emergency attendance, emergency medical readmission, emergency services utilization, quality of life, virtual ward |
| format |
article |
| author |
Leung DYP Lee DTF Lee IFK Lam LW Lee SWY Chan MWM Lam YM Leung SH Chiu PC Ho NKF Ip MF Hui MM |
| author_facet |
Leung DYP Lee DTF Lee IFK Lam LW Lee SWY Chan MWM Lam YM Leung SH Chiu PC Ho NKF Ip MF Hui MM |
| author_sort |
Leung DYP |
| title |
The effect of a virtual ward program on emergency services utilization and quality of life in frail elderly patients after discharge: a pilot study |
| title_short |
The effect of a virtual ward program on emergency services utilization and quality of life in frail elderly patients after discharge: a pilot study |
| title_full |
The effect of a virtual ward program on emergency services utilization and quality of life in frail elderly patients after discharge: a pilot study |
| title_fullStr |
The effect of a virtual ward program on emergency services utilization and quality of life in frail elderly patients after discharge: a pilot study |
| title_full_unstemmed |
The effect of a virtual ward program on emergency services utilization and quality of life in frail elderly patients after discharge: a pilot study |
| title_sort |
effect of a virtual ward program on emergency services utilization and quality of life in frail elderly patients after discharge: a pilot study |
| publisher |
Dove Medical Press |
| publishDate |
2015 |
| url |
https://doaj.org/article/56cc0fd5ea0e47c5ad68d253ca6611ea |
| work_keys_str_mv |
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