Donovan et al. (2016) found that transitional care interventions that are meant to start following the discharge of elderly patients from a skilled nursing facility, but are delayed, are likely to be ineffective in lowering incidence of adverse events and re-hospitalization rates. There are several reasons why the risk of adverse outcomes is high in this population, including the poor flow of information to physicians. In addition, it is also possible that a potential absence of care continuity may also cause more medical difficulties for this population. Other factors may include incomplete information transfer, inadequate caregiver information, and health literacy issues (Berkowitz et al., 2013).
This study used pre-post analysis of re-hospitalization for 30 days following discharge from the SNF, as well as an analysis of adverse effects within the first 45 days (Donovan et al., 2016). This proved a useful method for the measurement of care quality changes between the SNF environment and the home environment. In addition, this method also provided further knowledge of the current status of elderly patients released from the SNF, which could in turn offer further guidance for future improvements or interventions during the discharge of elderly patients. Nevertheless, the pre-post analysis method did not offer insights into whether the negative outcomes were a result of home-based factors or SNF-based factors (Berkowitz et al., 2013.
The results of the study point to the importance of home care in reducing the incidence of adverse events. In this case, the study’s findings would support an increased role for family caregivers in the support of older adults as part of their stay in the hospital, as well as after discharge, to manage the transition from the SNF to the home care environment (Neuman et al., 2014). Since the results show that delays in execution of transitional interventions cause re-hospitalizations, family caregivers should be highly engaged in the SNF’s decision-making concerning the older adult’s discharge plans (Neuman et al., 2014).
In turn, Bernocchi et al. (2014) found that telemedicine significantly improve the outcomes of patients with uncontrolled hypertension. Perhaps the biggest reason why hypertension is a good target for the implementation of telemedicine is because of the lack of follow-through by home care professionals, as well as the poor control of the condition by the patients. In this case, telemedicine enhances communication with the health team, while the patient is more involved with their healthcare at home, which improves high blood pressure outcomes for the patient (Kerby et al., 2012). Nevertheless, it is evident from the study that the efficacy of telemedicine in improving hypertension outcomes is based on providing patient education.
However, despite the positive outcomes of this study, the use of non-random sampling in selection of the sample introduces possible bias, while also making it difficult to estimate sampling variability (Kerby et al., 2012). In addition, this sampling method means that reliability cannot be assessed, specifically since the only way that data quality is assessable is through comparison of the results with population available from the population. Furthermore, this method made it difficult to measure the resulting sample’s precision, or even to ensure that the estimates meet acceptable levels of error. Therefore, one should exercise caution in generalizing the study’s results to the entire population of hypertensive patients under home care (Kerby et al., 2012).
Nevertheless, the results of this study are still important because there is evidence that telemedicine has a positive influence on at least part of the population with hypertension (Margolis et al., 2013). In this case, the information could be used to decrease the number of patients with hypertension who are currently under treatment but whose condition remains uncontrolled. Further, the results of this study point to the importance of conducting a randomized research, in which the researchers will allow for a longer follow-up to verify whether telemedicine is efficacious in reducing hypertension events (Margolis et al., 2013).