Health Care Hotspotting: A Scoping Review.

BACKGROUND: Super-utilizers of the health care system compose a small percentage of the population, yet use the most health care resources. Hotspotting addresses this issue by providing high-quality, personalized care to this population. PURPOSE: This review examined how hotspotting has been defined, implemented, and measured. METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guided this review. Twelve databases were searched for hotspotting interventions in practice settings. RESULTS: Sixteen studies were included. Hotspotting was primarily defined by the Camden Coalition of Healthcare Providers and relied on multiple professions, including nursing. Hotspotting interventions addressed access to care, social determinants of health, patient engagement, and health literacy. Some studies indicated that hotspotting reduced readmissions and emergency department visits and increased use in social services. CONCLUSIONS: Patients benefit from an interprofessional, personalized approach to their care planning. Hotspotting can lead to high-quality care through building trusted relationships.

Hotspotting in home health: The impact of interprofessional student-team home visits on readmission rates of super-utilizers of the health care system.

Studies have shown the impact of interprofessional education (IPE) on health professions students' knowledge, skills, and attitudes and, to some extent, its impact on patient and organizational outcomes. This retrospective quasi-experimental study explored the impact of home visits by teams of interprofessional health professions students on the readmission rates of patients recently discharged from the hospital. Patients (20 in the intervention group, 20 in the control group) were in the care of one home health agency during a 7-month period. The patient groups were similar in terms of gender (55% male, 45% female) and age (mean about 73). The model implemented in this study, referred to as hotspotting, is designed to improve patient outcomes, decrease readmissions, and decrease costs. Twelve student participants included two pharmacy, three public health, three occupational therapy, three nursing, and one medical student. Student teams performed 32 total visits. There was a significant difference between the 30-day hospital readmission rate for the intervention group and the 30-day hospital readmission rate for the control group (ᵡ2 = 4.286, df = 1, p = .038). While limited by sample size, this study warrants a closer examination of hotspotting in home health as an effective way to improve patient outcomes and decrease costs.

Interprofessional communication in the care of adults with cancer: exploring clinicians' perceptions of team rounding.

Interprofessional communication (IPC) is important for the inpatient oncology team due to the complexity and acuity of oncology patients. One intervention used to improve IPC is team rounding, yet few researchers have explored experiences of team members with team rounding. In this study, 12 interviews were conducted with providers from five different professions: Nursing Assistant, Registered Nurse, Pharmacist, Advanced Practice Provider, and Physician. We aimed to identify communication barriers and explore providers' perceptions of team rounding and IPC through semi-structured interviews on the adult inpatient oncology unit. Interviews were coded and conventional content analysis used. Facilitators identified were: effective team communication: (a) including interprofessional stakeholders in rounding and communication; (b) the importance of "real-time" communication; and (c) team dynamics. Barriers identified were: effective team communication: (a) workflow-related issues and (b) team dynamics. Findings from this study indicate each profession had unique perceptions, but all had a positive outlook on the necessity of IPC in the delivery of optimal cancer care.