Preventable acute hospital admissions

Title

Preventable acute hospital admissions – terminology, characteristics, and development of an assessment tool for community-based nurses

Aim

To uncover and describe definitions and characteristics of preventable hospital admissions (ambulatory care sensitive conditions (ACSCs) in literature

To investigate what characterises acute hospital admissions

To develop and test a risk assessment tool for use in primary care in order to prevent certain acute admissions effectively.

Design and methods

The project consists of three sub-studies:

1) A scoping review of the terminology of preventable (ACSCs) hospital admissions.

2) A population-based, multicenter observational register-based study of acute hospital admissions based on data from 5 acute medical units in Denmark. The study consists of descriptive statistics on patient characteristics, risk factors, and prevalence of ACSCs and subgroup analyses of patients with complex chronic conditions (multimorbidity).

3) An intervention study, in which an assessment tool for primary healthcare workers is developed and tested. The intervention is based on findings from studies 1 and 2.

Perspective

According to recent Danish political health reform initiatives, non-complicated treatments of patients with chronic diseases must be moved from secondary care to primary care settings to take the pressure of hospitals. However, the research-based knowledge on how to construct care pathways for these patients with an increased risk of hospital admissions due to ACSCs is limited. Large-scale population-based studies rather than disease-specific studies are needed to fill out the knowledge gap in order to understand the who, why and when in acute hospital admissions and thereby be able to design and improve effective preventive interventions in primary care. Nurses are expected to handle the complexity in chronic disease management in primary care settings. Hopefully, results from this study can contribute to advances in the nurses’ role in early prevention.

Collaborators

Marianne Lisby, PhD MScH RN, Research Centre for Emergency Medicine, Aarhus University Hospital, Department of Clinical Medicine, Aarhus University

Sidsel Vinge,PhD MSc(Econ.), VIVE – The Danish Center of Social Science Research

Mette Geil Kollerup, PhD MScN RN, Clinical Nursing Research Unit, Aalborg University Hospital

Patricia Dykes, PhD MA RN, Harvard Medical School, Brigham and Women’s Center for Nursing Excellence, Boston, USA