Suchergebnisse

Patient navigation is a model of care that aims to improve access to care by reducing the complexity of navigating health, education, and social services across the continuum of care and care settings. Little is known about the processes that facilitate or impede the implementation of patient navigation programs (PNPs). We conducted a scoping review to identify and summarize the current state of knowledge regarding the implementation and outcomes of existing implemented PNPs. We employed a 6-stage scoping review framework to identify and review eligible articles. Sixty-articles met the inclusion criteria (58 peer-reviewed and 2 grey literature). The Consolidated Framework for Implementation Research served as the theoretical framework during analysis to help extract factors relevant to implementation of navigator programs. Results of the scoping review are reported thematically. Influences on implementation were identified: (a) planning to ensure alignment with organizational need (b) funding (c) multidisciplinary engagement (d) establishing workflow (e) mechanisms for communication (f) stakeholders to encourage buy-in (g) appropriate caseload (h) in kind resources. PNPs improve the experiences of patients and families. The findings of this scoping review provides implementation considerations of PNPs across global care settings. Strategies for overcoming pragmatic and logistical issues must be developed for optimal implementation.

Anecdotal reports suggest that adequate housing and transportation could be fundamental elements required to ensure quality of life (QOL) for people with mobility limitations. Certain home- and community-based services (HCBS) are also necessary to ensure that housing and transportation needs are met. Understanding QOL as it relates to housing and transportation is critical for people with mobility limitations but requires appropriate assessment of these constructs. The aims of this research were to explore the relationships between housing and transportation on QOL for people with mobility limitations, to describe the current conceptual measurement issues and to propose dimensions of access that could facilitate assessment of QOL as it relates to housing, transportation and HCBS. A critical review of the literature was conducted by experts in disability, QOL and access theory. While evidence indicated a potential influence of housing and transportation on QOL for people with mobility limitations, the relationships between these concepts were weak and inconclusive. Moreover, the measurement tools used lacked appropriateness to specifically measure these constructs. Approaching these measurement issues within an access theory may better position future research to address the housing, transportation and HSBS needs of people with mobility limitations. Future research may consider elements of availability, accessibility, accommodation, affordability, acceptability and awareness to ensure access for people with mobility limitations. A better understanding of QOL as it relates to housing, transportation and HCBS will improve the quality of research, which may in turn improve access of adequate services for people with mobility limitations.