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Implications on Domestic Non Profit Organizations of Japanese Home Care Service

Implications on Domestic Non Profit Organizations of Japanese Home Care Service

In addition, Japanese government formulated “Law of Social Personnel and Nursing Personnel” in 1987 and stipulated the professional knowledge, technol- ogy as well as the work ability they must master, it also introduced the qualifica- tion certificate system. In order to protect the rights and interests of the welfare personnel, “Social Personnel law”, “Staff Superannuation Law of Social Welfare Facilities” and “Welfare Personnel Protection Law” were all amended and in- troduced in 1992. In order to improve the professional accomplishment and quality of Japanese social personnel, especially those who were involved in the service of elderly, Japanese government carried out “Registered Social Personnel Law” in 1998, it required all the undergraduate students who majored in social work that they must complete the assigned courses and pass relevant national examinations [15]. It was because that Japanese government promptly issued these laws and regulations to encourage, discipline and manage social personnel, the quality of its non-profit organization members could be improved. As a re- sult, they could provide better and more specialized home care service for the elderly. Meanwhile, both the elderly and social ordinary people were increasing- ly satisfied and trust non-profit organizations.

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Analyses of the effectiveness of a Brazilian pediatric home care service: a preliminary study

Analyses of the effectiveness of a Brazilian pediatric home care service: a preliminary study

Background: Technological advances in health care currently provide better care conditions and have increased survival rates of premature infants, along with increasing the life expectancy of chronically ill children. In this context, the home care service has emerged as an effective tool for the treatment of this group of children. Thus, this preliminary study aimed at evaluating the effectiveness of the Home Care Service (HCS) with regard to pediatric care. Methods: A cross-sectional study was performed through a medical record analysis of a tertiary hospital in Minas Gerais/ Brazil. Two groups were compared: 36 patients from the HCS (home group) and 13 patients hospitalized with an indication for home care (hospital group). To analyze the effectiveness of HCS, we evaluated the number of readmissions, infection rate, number of procedures, and optimization of beds.

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Relationship between home care service use and changes in the care needs level of Japanese elderly

Relationship between home care service use and changes in the care needs level of Japanese elderly

Various effects have been produced by different types of home care service programs. The Japanese LTCI system is a multidimensional service program that provides social and medical services [21]. A report suggests that the utili- zation of home based services is more closely related to the needs of caregivers than the care needs level of the users [1]. Although multidimensional services and care needs levels are included in home based services studies, they have not been thoroughly studied [22,23]. Also, a small number of related studies in Japan [24,25] set care needs level as a main outcome, but those studies targeted only the mildly disabled elderly and not the severely dis- abled. There is still insufficient evidence regarding the effectiveness of components of home based services on care needs level. As a first step to determine the effect of service use on care needs level, an observational study to identify the relationship between home based service and changes in care needs level is necessary. We conducted a study to describe the differences in home service use

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Discrepancies in assessing home care workers’ working conditions in a Norwegian home care service: differing views of stakeholders at three organizational levels

Discrepancies in assessing home care workers’ working conditions in a Norwegian home care service: differing views of stakeholders at three organizational levels

Research indicates that home care workers (HCWs) are at risk of a multitude of occupational stressors, health com- plaints and sick leave [1–9]. Interventions primarily aimed at reducing occupational exposures and improving health rarely succeed in reaching their stated objectives [10–13]. In 2003 the municipality in this study received orders from the Norwegian Labor Inspectorate due to a high level of unhealthy time pressure and high sick leave in the home care services (HCS). The municipality responded promptly by giving work environment interventions and other alleviating actions high priority. Findings, based on data from 2009, indicated that the work environment in- terventions in general were perceived by the HCWs to have a positive effect by improving targeted areas identi- fied to cause work strain. However, concurrent changes in- duced through production system rationalization, such as unit mergers, restructuring, changes to middle- and execu- tive management, and introduction of new technology and new work programs, resulted in negative exposure effects that negated the positive intervention effects, causing an overall deteriorated work situation [11]. Production system rationalization involves a continuous effort to reduce costs and improve quality of an organization’s output (e.g. ser- vices offered to patients), and has a predominant negative impact on worker health [10]. The majority of HCWs in the present case reported an increase in perceived time pressure from 2004 to 2009. They reported exposure to several occupational risk factors and a high prevalence of musculoskeletal health complaints [6]. Sick leave rate remained high the next two years; 19.1 % in 2011 vs. 18.1 % in 2009, compared to 15.6 % in 2004. Consequently, the HCS seems to be struggling with persistent challenges that are difficult to overcome.

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A Model for Ageing-Home-Care Service Process Improvement

					                Yu and Shie

A Model for Ageing-Home-Care Service Process Improvement Yu and Shie

The fourth solution deals with the application of home care services. Common physical care services (e.g., assistance in bathing and rehabilitation) could be outsourced independently to nursing homes in the ageing person’ s nearby community. Meanwhile, meal delivery services could also be provided by general restaurants, although meal arrangements for ageing people must follow the suggestions of professional nutritionists or nurses who understand their health conditions. These innovative solutions have the potential to minimise the transportation costs and waiting times for these home care services. In addition, ageing people can be divided based on their needs, age group, health conditions, and medical records to provide wide-spread customised service. For example, ageing people’s health conditions can be divided into four levels (e.g., no, mild, moderate, or severe diabetes mellitus) such that the home care service agency can arrange different types of healthy meals in accordance with each ageing person’s health condition.

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Identifying patients suitable for palliative care   a descriptive analysis of enquiries using a Case Management Process Model approach

Identifying patients suitable for palliative care a descriptive analysis of enquiries using a Case Management Process Model approach

The case manager decides about the admission to a pal- liative service of the department. For this study, the rea- sons for admission to the palliative care ward, palliative home care service or palliative consultation service were reported by the case management. For each admission, one or two main reasons were documented. The most frequently mentioned reason for admission to the pallia- tive care ward and to the palliative consultation service was the treatment of pain and other symptoms (88.5% and 87.9%, respectively). This was also an important rea- son for admission to the palliative home care service (35.0%). For 88.3% of admissions to the palliative home care service the need for nursing care was the main objective. Compared to admissions to the palliative home care service, the need for psychosocial support was mentioned more often in connection with admis- sions concerning the inpatient sector (6.9% and 8.6%, respectively).

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Development of a set of process and structure indicators for palliative care: the Europall project

Development of a set of process and structure indicators for palliative care: the Europall project

Sixhundred-thirtyfive QIs were derived from this literature review. After screening of duplicates, selecting process and structure QIs and combining QIs covering the same topic, the remaining 151 QIs were organised in the frame- work and discussed in the first steering group meeting. The two steering group meetings resulted in a reduction from 151 to 110 QIs (Additional file 1: Appendix C) (Figure 2). For instance the domain about finance QIs was excluded for the final set as the QIs were more useful on national level than in the setting specific palliative care institutions.

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Design of a case management model for people with chronic disease (Heart Failure and COPD)  Phase I: modeling and identification of the main components of the intervention through their actors: patients and professionals (DELTA icE PRO Study)

Design of a case management model for people with chronic disease (Heart Failure and COPD) Phase I: modeling and identification of the main components of the intervention through their actors: patients and professionals (DELTA icE PRO Study)

Methods/Design: Objectives: General: To develop the first and second phases (theorization and modeling) for designing a multifaceted case-management intervention in people with chronic conditions (COPD and heart failure) and their caregivers. Specific aims: 1) To identify key events in people living with chronic disease and their relation with the Health Care System, from their point of view. 2) To know the coping mechanisms developed by patients and their caregivers along the story with the disease. 3) To know the information processing and its utilization in their interactions with health care providers. 4) To detect potential unmet needs and the ways deployed by patients and their caregivers to resolve them. 5) To obtain a description from patients and caregivers, about their itineraries along the Health Care System, in terms of continuity, accessibility and comprehensiveness of care. 6) To build up a list of promising case-management interventions in patients with Heart Failure and COPD with this information in order to frame it into theoretical models for its reproducibility and conceptualization. 7) To undergo this list to expert judgment to assess its feasibility and pertinence in the Andalusian Health Care. Design: Qualitative research with two phases: For the first five objectives, a qualitative technique with biographic stories will be developed and, for the remaining objectives, an expert consensus through Delphi technique, on the possible interventions yielded from the first phase. The study will be developed in the provinces of Almería, Málaga and Granada in the Southern Spain, from patients included in the Andalusian Health Care Service database with the diagnosis of COPD or Heart Failure, with the collaboration of case manager nurses and general

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Economic valuation of informal care provided to people after a myocardial infarction in France

Economic valuation of informal care provided to people after a myocardial infarction in France

Data was collected from the prospective 2008 Health and disabilities households survey (Enquête Handicap- Santé), carried out in the French general population by the French National Institute of Statistics and Economic Studies and the Department of Research, Studies, Evalu- ation and Statistics. The first part of this survey, named Handicap-Santé, volet Ménages (HSM) [21], was conducted in ordinary households and collected socio-demographic, economic and health information from approximately 30, 000 participants. It examined the consequences of health problems on functional limitations, care-seeking (profes- sional and informal), professional and daily activities, and degree of dependence. Degree of dependency was deter- mined in the survey according to the Katz Index of Inde- pendence in ADLs (bathing, dressing, go and using the toilet, getting in and out of bed and enter then leave his seat, incontinence and feeding) [23]. This instrument is used to assess functional status as a measurement of ability to perform activities of daily living activities. People were scored for dependence in each of six activities. A score of 6 indicates that individual was able to make the 6 ADLs, and below six an impairment to realize at least one ADL. In the present study, care receivers with a score equal to 6 were classified as “autonomous to realize the 6 ADLs” and below 6, individuals were classified in the “not able to realize at least one ADL” category. The second part of the survey, Handicap-Santé, volet Aidants informels (HSA) [22], was based on telephone or face-to-face interviews with ap- proximately 5000 informal caregivers of the people interviewed in the first part of the survey. Information was collected about personal characteristics, profes- sional activity, social environment, description of care provided (type of activity and number of hours per week) and impact of provided care on family, profes- sional and social environment.

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Development of a set of process and structure indicators for palliative care: the Europall project

Development of a set of process and structure indicators for palliative care: the Europall project

Sixhundred-thirtyfive QIs were derived from this literature review. After screening of duplicates, selecting process and structure QIs and combining QIs covering the same topic, the remaining 151 QIs were organised in the frame- work and discussed in the first steering group meeting. The two steering group meetings resulted in a reduction from 151 to 110 QIs (Additional file 1: Appendix C) (Figure 2). For instance the domain about finance QIs was excluded for the final set as the QIs were more useful on national level than in the setting specific palliative care institutions.

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Cluster randomised controlled trial of community mobilisation in Mumbai slums to improve care during pregnancy, delivery, postpartum and for the newborn

Cluster randomised controlled trial of community mobilisation in Mumbai slums to improve care during pregnancy, delivery, postpartum and for the newborn

There will be two types of interim analysis. (1) An analysis of baseline findings, particularly neonatal mortality and care-seeking practices. The analysis will not look at out- comes in terms of allocation. The results will provide us with estimates of neonatal mortality rates on the basis of which cluster size will be reviewed. (2) An interim analysis of outcomes. This will be conducted in late 2008. The anal- ysis will look at the outcomes in terms of allocation. At this point a Data Safety Monitoring Board (DMB) will be convened according to the DAMOCLES statement.[42] The DMB will examine the study for deviations from pro- tocol and preliminary results. It is unlikely that a commu- nity mobilisation intervention will have adverse effects. From our experience in other, similar studies, we do not intend to institute stopping rules. However, if there are social or political problems in specific clusters, each situ- ation will be judged on its merits and the trial can be stopped if necessary. The DMB will also advise on whether the trial should be extended to achieve greater power. Analysis strategies

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Quality Assurance Policies and Indicators for Long-Term Care in the European Union, Country Report: Germany. ENEPRI Research Report No. 104, February 2012

Quality Assurance Policies and Indicators for Long-Term Care in the European Union, Country Report: Germany. ENEPRI Research Report No. 104, February 2012

According to self-administration, the assessment of care needs is not carried out by an institution of the state but by the insurance funds. The Medical Advisory Service of the Statutory Health Insurance Funds performs the assessment to determine whether an individual is entitled to benefits. These assessments are done primarily by geriatric nurses and physicians, who observe both the home and social environment of the person in need of care and examine the individual’s health and functional status on the basis of national standards. The detailed guidelines on the assessment procedures and standards are specified and drawn up by the Medical Advisory Board. These rules are agreed by all the parties involved; they apply nationwide and are binding (MDS, 2006). The Medical Advisory Board is also responsible for the external oversight of quality in care provision in homes as well as among home services. The various forms of long-term care offered under German legislation include benefits for caregiving at home in cash and in kind, in day or night care institutions and in nursing homes (Schulz, 2010). Beneficiaries may choose among different benefits and services. As caregiving at home by informal carers has priority, the majority of the beneficiaries – some 1 million out of 2.3 million – received benefits in cash in 2009. That means that they received care solely by an informal carer. Another 0.6 million people received benefits in kind or a combination of benefits in kind and in cash at home. These people received care and help by professional home-care services. Some 0.7 million people in need of care live in nursing homes. Care is provided by private, charitable, non-profit and public organisations. In 2009, there were 11,634 nursing homes and 12,026 professional home-care services. Thus, quality assurance must apply to three types of caregiving – at home by informal carers, at home by home care services and in nursing homes. Measurements of the quality of care, quality control and improvements in the quality of care have to be adjusted for the different types of care provision.

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The treatment of hypertension in care home residents: a systematic review of observational studies

The treatment of hypertension in care home residents: a systematic review of observational studies

retrospectively analyzed data, 2 used the results of the US National Nursing Homes Survey, 15,16 2 used databases compiled with information from the minimum dataset used in the United States and Canada for all nursing home admissions, 12,20 the 2 UK studies used databases built using data held by general practitioners, 7,21 and the remaining 2 retro- spectively analyzed digital and hard copy data from nursing homes. 11,22 The selection method was not reported in 3 of the studies, 11,19,24 and in 4 studies the nursing homes involved were af fi liated with the local university or medical center. 13,14,18,25 Two studies used data from the National Nursing Home Survey, a nationally representative sample of US nursing homes. 15,16

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Multimodal Human Machine Interaction for Service Robots in Home Care Environments

Multimodal Human Machine Interaction for Service Robots in Home Care Environments

A link to the world-wide web is established by integration of an easy-to-use web browser which is seamlessly integrated into the GUI. To counter- act isolation an event search web service was real- ized (Khrouf and Troncy., 2011) that visualizes var- ious events and corresponding pictures to the user that have taken place or will take place close to the user’s location. To achieve this the robot connects to an online event search service. The service will provide him/her with a personalized selection of so- cial event near his/her current location and personal preferences.

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Preventing Workplace Violence for Healthcare and Social Service Workers

Preventing Workplace Violence for Healthcare and Social Service Workers

When an incident occurs, the immediate first steps are to provide first aid and emergency care for the injured worker(s) and to take any measures necessary to prevent others from being injured. All workplace violence programs should provide comprehensive treatment for workers who are victimized personally or may be traumatized by witnessing a workplace violence incident. Injured staff should receive prompt treatment and psychological evaluation whenever an assault takes place, regardless of its severity—free of charge. Also, injured workers should be provided transportation to medical care if not

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Measuring dementia carers' unmet need for services   an exploratory mixed method study

Measuring dementia carers' unmet need for services an exploratory mixed method study

Assisted by the provision of only modest service hours, carers who participated in this study were able to support care recipients to remain at home until they reached moderate to severe stages of dementia. Carers such as these make an important contribution to the health care system and save health and social services significant costs thereby benefiting the public purse. In line with pre- vious research [9,10] however, we found that caring for a person with dementia brings social, emotional, physical and financial costs to the carers themselves, with our par- ticipants identified as more stressed than their non-care- giving peers according to the GHQ-30. This stress high- lights the importance of addressing carers unmet service needs, if policy makers wish them to maintain care in the home for extended periods. Our results suggest that car- ers' stated (felt) service needs should be considered a 'red flag' by service providers.

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The Optimal Study: Describing the Key Components of Optimal Health Care Delivery to UK Care Home Residents: A Research Protocol

The Optimal Study: Describing the Key Components of Optimal Health Care Delivery to UK Care Home Residents: A Research Protocol

Although we are using inter-RAI to control for baseline variability, we will not employ a recognised and validated long-term care quality tool, such as Inter-RAI or the Dutch LPZ 22 , as an outcome measure. This was a conscious choice. Such measures are not in routine use in the UK and which conceptual model of care quality to use in care homes is a source of considerable debate. In seeking to describe real-world models of health care, we sought to describe them using the outcomes that are routinely used by NHS commissioners, which are those described above. Whilst the introduction interRAI or LPZ - or data on prevalence of individual care problems in care homes - into the research protocol as outcome measures might start to address the issue of their feasibility and applicability in routine care practice in the UK care setting, this is a separate research question to that described here.

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A Patient Reported Experience Measure (PREM) for use by older people in community services

A Patient Reported Experience Measure (PREM) for use by older people in community services

Understanding services from a user perspective is critical in the delivery of person-centred, integrated care. Successful rehabilitation should be based on goal directed and individualised care [14]. Person-centred care is therefore especially important in intermediate care services where rehabilitation is a major component of care. The systematic and routine evaluation of person- centred care requires robustly developed assessment tools. The two intermediate care PREMs were developed with these requirements in mind. They utilised existing questions that had undergone prior sense and field testing. Specific question selection involved a consensus process with panels of patients and public, practitioners, managers and academics. The PREMs were developed to be used across a spectrum of intermediate care services for the purposes of local service improvement rather than between service comparisons.

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Service evaluation of community based palliative care and a hospice at home service

Service evaluation of community based palliative care and a hospice at home service

The participants highly valued having the hospice-at home team available in person to come to patients’ homes to perform a range of procedures such as setting up and managing syringe drivers for symptom control or on the telephone for advice and support. Such interventions were perceived to prevent patients having unnecessary admissions to acute hospitals. Having one telephone number to ring, at any time of the day or night, was appreciated by all the participants. This made accessing the system straightforward and clear. The hospice telephone line was accessed in preference to other services as it was known that the caller would be able to speak immediately to a clinician and not have to leave a message on an answerphone and be unsure that the call would get returned. However, all the participants would have liked the visiting service to be available over the 24-hour period and for 7 days a week in the same way that the telephone service could be accessed. Out-of-hours GPs were perceived not to have access to some patients’ notes and information, and consequently could not provide the most appropriate care. These findings support those of other studies of hospice at home services. Rhodes et al (2008) in their study of bereaved family members evaluation of hospice services concluded that a higher level of satisfaction was found when family members believed that hospice staff were knowledgeable about the patient and the specific care required and were available to be contacted for both clinical issues and emotional support. Butler and Holdsworth (2013) conducted a review of the literature relating to hospice at home services identifying certain attributes which led to positive outcomes. These included help for informal carers to manage stress and 24 hour access over 7 days to professionals who can provide specialist care and administer medications. Another study conducted by the National Association for Hospice at Home (Bell et al 2013) was undertaken to develop national standards for hospice-at-home services. The standards produced included working in partnership with other agencies to meet the needs of patients, carers and families, communicating clearly defined referral criteria to stakeholders and other partners, and the provision of hospice-at-home care and support services which enables families and carers to make informed decisions and receive advice and support. All of these issues were identified as being essential in order to provide a high quality of end of life care. The findings from these studies carried out in other areas indicate that the issues raised in this current study are in alignment with those found in other areas of the country.

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Improving home care quality: an individual-centered approach

Improving home care quality: an individual-centered approach

It might be feasible for an audit to compare Home Care providers concerning types of requests voiced by clients, types of requests which staff are instructed to meet, and evidence of success in meeting them. But sensitive investigation of reasons for differences would be required, noting the complex relationship between special requests and the characteristics of routine service. Another challenge for audit concerns recognising adjustments for individual clients which may be so longstanding that clients take them for granted. Also, sometimes individual adjustments are implemented rather covertly by Home Care staff, who may conceal from supervisors some of their kindness to clients lest it be deemed contrary to regulations (Sinclair et al 2000). If feasible, audit might identify which models for organising Home Care teams are best for meeting many, varied service user preferences. How a service is organised can greatly affect its flexibility for meeting preferences like service through familiar staff, service at chosen times, or occasional extra tasks.

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