Retrospective Evaluation of Discharge Planning Linked to a Long-Term Care 2.0 Project in a Medical Center.

BACKGROUND: Although there are several studies on discharge planning and long-term care systems in individual programs, research on the connection between discharge planning and the usage of long-term care is scanty. This study aims to evaluate the nature of the association between discharge planning (DP) and long-term care (LTC) and whether the utilization of LTC services improved after being discharged. METHODS: This was a single-center retrospective medical record review study. Secondary data analysis was conducted of DP-LTC participation data between 2018 and 2019. The objectives were to clarify the distinct characteristics of each part of the service to explore the utility rate by overall users and users with willingness and to determine the factors influencing their usage. Medical claims were used to identify inpatients receiving discharge services, and data were matched with LTC system engagement data (n = 2155). Backward stepwise regression was used to explore the attributes associated with each type of service use. RESULTS: A total of 94% (2042/2155) of inpatients expressed a perceived need for LTC services, of which 14% (285/2042) were users of LTC services after discharge. When assessed by case-mix system (CMS) and willingness to use services during hospitalization, inpatients had higher rates of service utilization after discharge. Using LTC services was most likely to be associated with obesity, disability, high CMS level, higher education, and women. CONCLUSION: The study confirms that the utilization of LTC services has improved under the integrated DP-LTC system. The gap between willing and actual users is worth considering. In the assessment stage, special attention should be paid to the service needs of persons with BMI ≥ 27 and disabilities. Future research with a larger sample could comprehensively evaluate the impact of integrated DP services on the use of LTC 2.0 service resources.

Factors Affecting Patients' Acceptance of and Satisfaction with Cloud-Based Telehealth for Chronic Disease Management: A Case Study in the Workplace.

OBJECTIVE: Understanding patients' acceptance of and satisfaction with telehealth use is important for workplace health promotion. In this study, we used a questionnaire to measure patients' usage behavior and satisfaction with cloud-based telehealth services in the workplace. We empirically investigated the factors that influence patients' usage and satisfaction based on data collected from 101 participants. METHODS: As its main research framework, this study utilized a revised version of the technology acceptance model 2 that was based on the telehealth services provided for chronic disease management. Through integrating a cross-sectional research design with an author-developed structured questionnaire that was assessed using reliability and validity tests, an anonymous survey was conducted on selected participants. The proposed research model and hypotheses were validated through path analysis using SPSS. RESULTS: We found that users believe telehealth services can promote their workplace health management; that job relevance, result demonstrability, and perceived ease of use (PEOU) positively affect the perceived usefulness (PU), which implies that cognitive instrumental processes have the most significant impact on the PU of cloud-based telehealth; and that both PEOU and PU positively affect the intention to use (IU), but PU has a bigger influence than PEOU on users' intentions to continue using telehealth. In particular, the IU and actual usage behavior were critical to the patients' satisfaction with telehealth services. CONCLUSION: This research contributes to the rapid developing field of technology acceptance research by examining workplace telemedicine engagement. Our results will provide researchers with useful advice and a user-centered strategy for promoting workplace health management, which benefits both health care providers and corporate managers.

[An experience promoting evidence-based nursing at a medical center in central Taiwan].

In the 21st Century, evidence-based nursing (EBN) may provide a mechanism by which nurses can manage the explosion in published information in the literature, introduce new techniques, effectively control healthcare costs, and increase attention on nursing quality and health outcomes. The objective of this paper is to share the experience implementing evidence-based nursing. We had applied strategies to implement evidence-based nursing care in our hospital since 2002. Over a more than three-year period (January 2002 to October 2005), we held 46 basic course sessions (around 1,840 attendees) and 58 advanced course sessions (around 500 attendees). There are 445 clinical questions with answered reports, Most questions related to foley care, central vein care and peripheral intravenous injection. Our nursing department revised three guidelines on nursing care skills related to suction and foley and nasal-gastric feeding to meet local conditions. Based on our subjective experience, promotion and implementation of EBN is feasible and helpful to update knowledge and decrease variance in clinical nursing care. However, further outcome research is needed in the future in order to obtain more objective evidence.