Results of the Unité de soutien SSA Québec’s demonstration project
The CONECT-6 tool was developed and implemented in a clinical setting as part of the demonstration project begun by the Unité de soutien SSA Québec in 2016 to demonstrate the value and benefits of the Learning Health System (LHS). Led by an interprofessional team that involved patients and their loved ones, the CONECT-6 project embodied a research continuum, from the structured collection and use of data to creating tools to support decision-making and ultimately integrating the knowledge acquired into clinical and organizational practices.
Context
Early intervention with patients at risk of high use of emergency services makes it possible to provide services, such as case management, that are better adapted to their needs. The case-finding process is key to making this type of intervention effective. A quick and easy-to-use case-finding tool would help emergency department teams achieve this goal while reducing the cost of services due to avoidable visits and hospitalizations.
Objective
The objective of the study is to develop and validate a short self-assessment tool to identify adult patients with chronic conditions and complex health needs.
Method
The study was carried out in four emergency departments:
- two in Saguenay–Lac-Saint-Jean
- two in Estrie
Adult patients with at least one chronic condition were approached to participate in the study upon their third visit to the emergency room or beyond in the previous 12 months. Volunteers were asked to complete a self-administered questionnaire that included:
- socio-demographic data
- a comorbidity index
- a standard reference tool (INTERMED Self-Assessment)
- 12 variables that were identified in previous work to develop the screening tool
Results
A total of 290 patients participated in the study. A multivariate analysis led to the development of a six-question dichotomous tool with yes or no answers.Named CONECT-6 for “COmplex NEeds Case-finding Tool – 6,” the tool assesses the following variables:
- poor perceived health
- limitations due to pain
- unmet needs
- high perceived complexity
- low income
- low social support
Conclusion
CONECT-6 is the first case-finding tool to rapidly identify patients suffering from chronic disease with complex health needs.