Enhancing the efficacy of healthcare information websites: a case for the development of a best practice framework.

Online healthcare information has the potential to improve health outcomes via the widespread, cost-effective translation of research evidence into practice by healthcare professionals and use by consumers. However, comparatively little is known about how healthcare professionals and consumers engage with healthcare websites, or whether the knowledge that is made available through digital platforms is translated into better health outcomes. To realise the potential of such resources, we argue that an evidence-based framework-grounded in a nuanced understanding of how audiences engage with and use information provided by healthcare websites-is needed. The goal of this paper is to outline a case for the development of a best-practice framework that can guide the development of websites that provide healthcare information to clinicians and consumers. In addition to supporting the design of more effective online resources, a common framework for understanding how better health outcomes can be achieved via digital knowledge translation has the potential to significantly improve patient outcomes in the face of a complex, rapidly changing and resource-constrained healthcare landscape.

Towards reduction of preventable hospital readmission: Older people and family members' views on planned self-management of care at home.

AIMS AND OBJECTIVES: To reduce the likelihood of preventable readmissions, the aim was to investigate how older people (with their family members) managed their chronic health conditions at home following hospital discharge. The objectives explored older people and their family members' perspectives on how discharge plans assisted self-management of their chronic conditions, their recognition of deterioration and when to seek treatment/re-attend hospital. BACKGROUND: Chronic conditions have challenged older adults' self-management, particularly after hospital discharge and can impact on preventable readmission. Few studies have examined patients' and their family members' perspectives on the management of their conditions at home after hospitalisation. DESIGN: A qualitative exploratory design known as Interpretive Description was utilised. METHODS: Purposeful sampling involved 27 community-dwelling older adults; nineteen were discharged patients with one or more chronic health conditions. Eight nominated family members were also recruited to enhance understanding of the older persons' self-management at home. Interviews were undertaken and thematic data analysis followed the COREQ guidelines. RESULTS: Five themes emerged: (1) Post-Discharge Advice; (2) Managing at Home; (3) Recognition and Response to Deterioration; (4) Community Care and Support; and (5) The "Burden" on Others of Post-Discharge Care. CONCLUSION: Older people sought a clear plan for self-management at home prior to discharge. This plan should contain potential signs of deterioration and guidance on future action. We found that support given to older people from family and friends was critical to prevent readmission. In addition, their local General Practitioner and Pharmacist played an essential part in the support of their care. For some, social support services were also important. Nurse telephone follow-up in the week following discharge was mostly absent. However, this strategy would be strongly recommended. RELEVANCE TO CLINICAL PRACTICE: To mitigate against preventable readmission, we recommend the above strategies to assist the older person at home with self-management of their chronic conditions.