Evidence map›Paper›PMID 34992054›Full record

ArticleBMJ open quality2022

Establishing an alternative accommodation for stable hospitalised antepartum patients: barriers and challenges.

M Brad Sullivan, Abby Rentz, Pamela Mathura, Megan Gleddie, Tania Luthra, Allison T Thiele, Katharina Kovacs Burns, Rebecca Rich, Winnie W Sia

Open access · goldAbstract read
In one paragraph

Article in BMJ open quality, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
1.1field-weighted citation impact, top 22% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 3 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 2 institutions in 1 country.

M Brad SullivanUniversity of Alberta, Edmonton, Alberta, Canada.
Abby RentzUniversity of Alberta, Edmonton, Alberta, Canada.
Pamela MathuraUniversity of Alberta, Edmonton, Alberta, Canada.
Megan GleddieAlberta Health Services, Edmonton, Alberta, Canada.
Tania LuthraUniversity of Alberta, Edmonton, Alberta, Canada.
Allison T ThieleUniversity of Alberta, Edmonton, Alberta, Canada.
Katharina Kovacs BurnsUniversity of Alberta, Edmonton, Alberta, Canada.
Rebecca RichUniversity of Alberta, Edmonton, Alberta, Canada.
Winnie W SiaUniversity of Alberta, Edmonton, Alberta, Canada winnie.sia@ahs.ca.
University of Alberta · CAAlberta Health Services · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPatients in remote communities who risk premature delivery require transfer to a tertiary care centre for obstetric and neonatal care. Following stabilisation, many patients are candidates for outpatient management but cannot be discharged to their home communities due to lack of neonatal intensive care unit (ICU) support. PROBLEM: Without outpatient accommodation proximal to neonatal ICU, these patients face prolonged hospitalisation-an expensive option with medical, social and psychological consequences. Therefore, we sought to establish an alternative accommodation for out-of-town stable antepartum patients.

methodsQuality Improvement approaches were used to identify process strengths and opportunities for improvement on the antepartum ward in a tertiary care centre. Physician and patient surveys informed outpatient accommodation programme development by a multidisciplinary team. The intervention was implemented using a plan-do-study-act cycle. Barriers to patient discharge and enrolment in the programme were analysed by completing thematic and strengths-weaknesses-opportunities-threats (SWOT) analysis.

resultsPhysicians broadly supported safe outpatient management, whereas patients were hesitant to leave the hospital even when physicians assured safety. Our alternative accommodation was pre-existing and cost-effective, however, we encountered significant barriers. The physical space limited family visits and social interaction, lacked desired amenities,and the programme proved inconvenient to patients. The thematic and SWOT analysis identified aspects of the intervention which can be optimised to develop future actionable strategies.

conclusionThe utilisation of acute care beds is costly for the healthcare system and must be allocated judiciously. Patient needs, experience and health system barriers need to be considered when establishing alternative outpatient accommodations and strategies for stable antepartum patients.

Indexed as

Critical CarePatient DischargeDelivery of Health CareFemaleHumansInfant, NewbornIntensive Care Units, NeonatalPregnancyTertiary Care Centerslength of staymaternal health servicespatient satisfactionquality improvement

Identifiers

PMID34992054
PMCPMC8739065
OpenAlexW4206733901

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.