Care Transitions Intervention and Other Non-nursing Home Transitions Models

Bowman, Ella Harvey; Flood, Kellie L.

doi:10.1007/978-3-319-16068-9_8

Cited by 3 publications

(3 citation statements)

References 52 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A care transition is defined as the movement of a patient between different healthcare settings, and/or between health care providers [ 5 ]. In addition, these older adults may have multiple care transitions between health settings (e.g., acute care to convalescence to home) [ 6 ]. However, these older adults rarely have cohesive treatment plans due to the lack of coordination amongst different health care providers [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Use of participatory visual narrative methods to explore older adults’ experiences of managing multiple chronic conditions during care transitions

Backman

Stacey

Crick

et al. 2018

BMC Health Serv Res

View full text Add to dashboard Cite

BackgroundOlder adults with multiple chronic conditions typically have more complex care needs that require multiple transitions between healthcare settings. Poor care transitions often lead to fragmentation in care, decreased quality of care, and increased adverse events. Emerging research recommends the strong need to engage patients and families to improve the quality of their care. However, there are gaps in evidence on the most effective approaches for fully engaging patients/clients and families in their transitional care. The purpose of this study was to engage older adults with multiple chronic conditions and their family members in the detailed exploration of their experiences during transitions across health care settings and identify potential areas for future interventions.MethodsThis was a qualitative study using participatory visual narrative methods informed by a socio-ecological perspective. Narrated photo walkabouts were conducted with older adults and family members (n = 4 older adults alone, n = 3 family members alone, and n = 2 older adult/family member together) between February and September 2016. The data analysis of the transcripts consisted of an iterative process until consensus on the coding and analysis was reached.ResultsA common emerging theme was that older adults and their family members identified the importance of active involvement in managing their own care transitions. Other themes included positive experiences during care transitions; accessing community services and resources; as well as challenges with follow-up care. Participants also felt a lack of meaningful engagement during discharge planning, and they also identified the presence of systemic barriers in care transitions.ConclusionThe results contribute to our understanding that person- and family-centered care transitions should focus on the need for active involvement of older adults and their families in managing care transitions. Based on the results, three areas for improvement specific to older adults managing chronic conditions during care transitions emerged: strengthening support for person- and family-centered care, engaging older adults and families in their care transitions, and providing better support and resources.

show abstract

Section: Introductionmentioning

confidence: 99%

Use of participatory visual narrative methods to explore older adults’ experiences of managing multiple chronic conditions during care transitions

Backman

Stacey

Crick

et al. 2018

BMC Health Serv Res

View full text Add to dashboard Cite

show abstract

“…Poor coordination of care, along with inadequate communication both among providers and with patients and families, can result in provider and/or patient deviations from standardized clinical care pathways [2,5]. These care deviations are especially likely during transitions of care, and can lead to avoidable emergency department visits and hospital readmissions.…”

mentioning

confidence: 99%

“…These care deviations are especially likely during transitions of care, and can lead to avoidable emergency department visits and hospital readmissions. Improving transitional care, defined as ''a set of actions designed to ensure the coordination and continuity of healthcare as patients transfer between different locations or different levels of care within the same location'' [2,5], can reduce these potential events and improve the healthcare experience for patients and their families [11].…”

mentioning

confidence: 99%