Browsing by Author "Sevick, Laura"
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Item Open Access An Economic Evaluation of a Novel Electronic Discharge Communication Tool(2017) Sevick, Laura; Clement, Fiona; Ghali, William; Santana, MariaThe transition from acute-care hospitalization to community-based care is a vulnerable period in healthcare delivery due to potential for post-discharge adverse events. This vulnerability has been attributed to the miscommunication between acute and community-based physicians, as current systems do not control for legibility, completeness or timeliness of the discharge summary. One potential approach to bridging this communication gap is the use of electronic discharge communication tools, which can be designed to ensure the consistent and timely transfer of information. Given the limited healthcare budget, the costs and benefits of these tools should be considered prior to large scale implementation. Thus, the goal of this thesis is to establish the cost-effectiveness of electronic discharge communication tools. To achieve this, a systematic review of published literature was conducted (Chapter 2), a prospective economic evaluation of a novel electronic discharge communication tool was completed (Chapter 3), and policy options/considerations were presented (Chapter 4).Item Open Access Palliative care in the home: a scoping review of study quality, primary outcomes, and thematic component analysis(2018-03-07) Hofmeister, Mark; Memedovich, Ally; Dowsett, Laura E; Sevick, Laura; McCarron, Tamara; Spackman, Eldon; Stafinski, Tania; Menon, Devidas; Noseworthy, Tom; Clement, FionaAbstract Background The aim of palliative care is to improve the quality of life of patients and families through the prevention and relief of suffering. Frequently, patients may choose to receive palliative care in the home. The objective of this paper is to summarize the quality and primary outcomes measured within the palliative care in the home literature. This will synthesize the current state of the literature and inform future work. Methods A scoping review was completed using PRISMA guidelines. PubMed, Embase, CINAHL, Web of Science, Cochrane Library, EconLit, PsycINFO, Centre for Reviews and Dissemination, Database of Abstracts of Reviews of Effects, and National Health Service Economic Evaluation Database were searched from inception to August 2016. Inclusion criteria included: 1) care was provided in the “home of the patient” as defined by the study, 2) outcomes were reported, and 3) reported original data. Thematic component analysis was completed to categorize interventions. Results Fifty-three studies formed the final data set. The literature varied extensively. Five themes were identified: accessibility of healthcare, caregiver support, individualized patient centered care, multidisciplinary care provision, and quality improvement. Primary outcomes were resource use, symptom burden, quality of life, satisfaction, caregiver distress, place of death, cost analysis, or described experiences. The majority of studies were of moderate or unclear quality. Conclusions There is robust literature of varying quality, assessing different components of palliative care in the home interventions, and measuring different outcomes. To be meaningful to patients, these interventions need to be consistently evaluated with outcomes that matter to patients. Future research could focus on reaching a consensus for outcomes to evaluate palliative care in the home interventions.