Collaborating with healthcare providers to understand their perspectives on a hospital-to-home warning signs intervention for rural transitional care: protocol of a multimethod descriptive study

Abstract

IntroductionThis study builds on our prior research, which identified that older rural patients and families (1) view preparation for detecting and responding to worsening health conditions as their most pressing unmet transitional care (TC) need and (2) perceive an evidence-based intervention, preparing them to detect and respond to warning signs of worsening health conditions, as highly likely to meet this need. Yet, what healthcare providers need to implement a warning signs intervention in rural TC is unclear. The objectives of this study are (1) to examine healthcare providers’ perspectives on the acceptability of a warning signs intervention and (2) to identify barriers and facilitators to healthcare providers’ provision of the intervention in rural communities.Methods and analysisThis multimethod descriptive study uses a community-based, participatory research approach. We will examine healthcare providers’ perspectives on a warning signs intervention. A purposive, criterion-based sample of healthcare providers stratified by professional designation (three strata: nurses, physicians and allied healthcare professionals) in two regions (Southwestern and Northeastern Ontario, Canada) will (1) rate the acceptability of the intervention and (2) participate in small (n=4–6 healthcare providers), semistructured telephone focus group discussions on barriers and facilitators to delivering the intervention in rural communities. Two to three focus groups per stratum will be held in each region for a total of 12–18 focus groups. Data will be analysed using conventional qualitative content analysis and descriptive statistics.Ethics and disseminationEthics approval was obtained from the Office of Research Ethics at York University and the Health Sciences North Research Ethics Board. Findings will be communicated through plain language summary and policy briefs, press releases, manuscripts and conferences.

Healthcare providers’ perceived acceptability of a warning signs intervention for rural hospital-to-home transitional care: A cross-sectional study

“…This cross-sectional study was part of a larger multi-method project [22]. To maximize future uptake of the intervention in practice, the project was designed and conducted by academic researchers in collaboration with knowledge users (clinical and administrative leaders) [22].…”

“…Informed by a synthesis of the empirical literature [1,[15][16][17][18][19][20][21], we developed a comprehensive description of a warning signs intervention [22]. The goal of the intervention is for patients to know the indicators of worsening health conditions and how to respond [22].…”

“…Informed by a synthesis of the empirical literature [1,[15][16][17][18][19][20][21], we developed a comprehensive description of a warning signs intervention [22]. The goal of the intervention is for patients to know the indicators of worsening health conditions and how to respond [22]. The intervention begins in hospital with an appraisal of patients' health literacy, their knowledge of the warning signs related to their condition(s), and their capacity to detect and address those signs at home, as well as what they need to learn to address them appropriately [22].…”

“…The goal of the intervention is for patients to know the indicators of worsening health conditions and how to respond [22]. The intervention begins in hospital with an appraisal of patients' health literacy, their knowledge of the warning signs related to their condition(s), and their capacity to detect and address those signs at home, as well as what they need to learn to address them appropriately [22]. The intervention is delivered both prior to and after hospital discharge.…”

“…The intervention is delivered both prior to and after hospital discharge. To promote patient understanding, the intervention deploys the teach-back method, as well as educational materials that use lay language, symbols, and pictograms [22]. In our previous work, patients and their family caregivers rated the warning signs intervention as highly acceptable in preparing them to detect and respond to worsening health conditions [7], indicating that they would be very receptive to receiving it [23].…”