SHM Converge Scientific Abstract ePoster Gallery-Choosing High-Value Post-Acute Care: A Systematic Scoping Review

Pdf Summary

This systematic scoping review examined tools used to support decision-making about post-acute care (PAC) for older adults after hospitalization, a vulnerable transition associated with readmissions and institutionalization. The authors searched PubMed and CINAHL for studies published from January 1, 2011, to December 31, 2021, and included tools relevant to adults considering PAC or clinicians caring for them.<br /><br />The review found that clinicians were the most common intended users of PAC tools (81%). A total of 42 different tools were identified, most often in the stage of recognizing a need for PAC. The most frequently mentioned tools in that category were AMPAC 6-Clicks, ESDP, D2S2, and DIRECT. Tools were most often developed for surgical patient populations (47%).<br /><br />Across the PAC decision-making process, tools were identified for several steps: recognizing need for PAC, determining when to send a patient to PAC, deciding eligibility for specific PAC types, and selecting among PAC providers. Common provider-selection tools included Nursing Home Compare and its variants, Yelp, and Home Health Care resources. Some tools were prospectively tested, but this was uncommon.<br /><br />Evidence for implementation was limited. Only 24 studies (34%) included an intervention, and just 2 of those were randomized trials. Overall, the review suggests that many PAC decision-support tools exist, but they are unevenly distributed across decision stages and have limited rigorous evaluation. The authors conclude that better standardized, effective tools could improve PAC choices, outcomes, and costs.

Asset Subtitle

Jacqueline A. Benson

Meta Tag

Author List Jacqueline A. Benson, Kirstin M. Piazza, Leslie RM Hausmann, Marilyn M. Schapira, Robert E. Burke

Category Research

Concept Post-Acute Care

Concept Decision Support Tool

Concept Care Transition

Concept Level of Care

Concept AM-PAC 6-Clicks Bedside Tool

Distinguished Non-Finalist

Presenter Organization Center for Health Equity Research and Promotion

Presenting Author Jacqueline A. Benson

Track Transitions of Care

Keywords

post-acute care

older adults

decision-making tools

hospital discharge

readmissions

institutionalization

clinical decision support

care transition

nursing home compare

systematic scoping review

Post-Acute Care

Decision Support Tool

Care Transition

Level of Care

AM-PAC 6-Clicks Bedside Tool