Safety threats and opportunities to improve interfacility care transitions: insights from patients and family members

Abstract

Lianne Jeffs,1 Simon Kitto,1 Jane Merkley,2 Renee F Lyons,2 Chaim M Bell11Li Ka Shing Knowledge Institute, St Michael’s Hospital, Toronto, Ontario, Canada; 2Bridgepoint Health, Toronto, Ontario, CanadaAim: To explore patients’ and family members’ perspectives on how safety threats are detected and managed across care transitions and strategies that improve care transitions from acute care hospitals to complex continuing care and rehabilitation health care organizations.Background: Poorly executed care transitions can result in additional health care spending due to adverse outcomes and delays as patients wait to transfer from acute care to facilities providing different levels of care. Patients and their families play an integral role in ensuring they receive safe care, as they are the one constant in care transitions processes. However, patients’ and family members’ perspectives on how safety threats are detected and managed across care transitions from health care facility to health care facility remain poorly understood.Methods: This qualitative study used semistructured interviews with patients (15) and family members (seven) who were transferred from an acute care hospital to a complex continuing care/rehabilitation care facility. Data were analyzed using a directed content analytical approach.Results: Our results revealed three key overarching themes in the perceptions: lacking information, getting “funneled through” too soon, and difficulty adjusting to the shift from total care to almost self-care. Several patients and families described their expectations and experiences associated with their interfacility care transitions as being uninformed about their transfer or that transfer happened too early. In addition, study participants identified the need for having a coordinated approach to care transitions that engages patients and family members.Conclusion: Study findings provide patients’ and family members’ perspectives on key safety threats and how to improve care transitions. Of particular importance is the need for patients and family members to play a more active role in their care transition planning and self-care management.Keywords: safety threats, patient and family perspectives, care transitions