Disparate perspectives: Exploring healthcare professionals' misaligned mental models of older adults’ transitions of care between the emergency department and skilled nursing facility

Werner, Nicole E.; Rutkowski, Rachel; Krause, Sheryl; Barton, Hanna J; Wust, Kathryn; Hoonakker, Peter; King, Barbara J.; Shah, Manish N.; Pulia, Michael S.; Brenny-Fitzpatrick, Maria; Smith, Maureen A.; Carayon, Pascale

doi:10.1016/j.apergo.2021.103509

Cited by 6 publications

(3 citation statements)

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“…Across-system knowledge brokering may be an outcome of the fragmented health care system that patients navigate throughout their journey. Gaps in communication and coordination across care settings in the patient journey can be the consequence of many factors, including misalignment of mental models across work systems involved in care transitions (Werner et al, 2021). The diversity of roles identified in both within- and across-system knowledge brokering emphasizes the key role of patients and care partners as the only constant surrounding an ED visit.…”

Section: Discussionmentioning

confidence: 99%

“…As a constant in their care journey (Carayon & Wooldridge, 2019; Carayon, Wooldridge, Hoonakker, Hundt, & Kelly, 2020), patients and their care partners play a key role in the information flow across transitions and may help to close gaps in communication and coordination between care settings and clinicians resulting from misaligned work systems (Storm, Siemsen, Laugaland, Dyrstad, & Aase, 2014; Vincent & Amalberti, 2016; Werner et al, 2020; Werner et al, 2021). O’Hara, Canfield, & Aase (2019) suggest that patients and care partners contribute to communication and coordination during the patient journey through their role as knowledge brokers .…”

Section: Introductionmentioning

confidence: 99%

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Older Adult Patients and Care Partners as Knowledge Brokers in Fragmented Health Care

et al. 2022

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Objective To describe older adult patients’ and care partners’ knowledge broker roles during emergency department (ED) visits. Background Older adult patients are vulnerable to communication and coordination challenges during an ED visit, which can be exacerbated by the time and resource constrained ED environment. Yet, as a constant throughout the patient journey, patients and care partners can act as an information conduit, or knowledge broker, between fragmented care systems to attain high-quality, safe care. Methods Participants included 14 older adult patients ([Formula: see text] 65 years old) and their care partners (e.g., spouse, adult child) who presented to the ED after having experienced a fall. Human factors researchers collected observation data from patients, care partners and clinician interactions during the patient’s ED visit. We used an inductive content analysis to determine the role of patients and care partners as knowledge brokers. Results We found that patients and care partners act as knowledge brokers by providing information about diagnostic testing, medications, the patient’s health history, and care accommodations at the disposition location. Patients and care partners filled the role of knowledge broker proactively (i.e. offer information) and reactively (i.e. are asked to provide information by clinicians or staff), within-ED work system and across work systems (e.g., between the ED and hospital), and in anticipation of future knowledge brokering. Conclusion Patients and care partners, acting as knowledge brokers, often fill gaps in communication and participate in care coordination that assists in mitigating health care fragmentation.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Older Adult Patients and Care Partners as Knowledge Brokers in Fragmented Health Care

et al. 2022

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“…Overall Dr. Werner currently co-leads the UW-Madison PSLL, "Engineering Safe Care Transitions for Vulnerable Older Adults." Our PSLL is aimed at designing safe transitions for older adults across their care journey, beginning in the ED (Werner et al, 2021). Although older adults are at higher risk of harm as they transition through healthcare settings (Aminzadeh & Dalziel, 2002;Long & Vincent, 2012), these transitions also represent an opportunity to reduce risk.…”

Section: What Makes a Good Learning Lab Inmentioning

confidence: 99%

Patient Safety Learning Labs: Effective Collaborations for Enhanced Patient Safety

Xiao

Catchpole

Rodrick³

et al. 2022

Proceedings of the Human Factors and Ergonomics Society Annual

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Patient Safety Learning Labs (PSLL) are a program funded by US Agency for Healthcare and Quality, and represent a substantial investment by the US federal government to strengthen capacities for applying system engineering methods in healthcare to improve patient safety. Human factors professionals have been well represented in the program as investigators and consultants. This panel is composed of leaders in 4 PSLLs, as well as overall program leaders, to address questions on the PSLL program, roles of human factors professionals in the program, and considerations for success PSLLs. The panel will help those human factors professionals contemplating forming PSLLs or active in a PSLL, and solicit input from human factors communities on ways to achieve effective collaborations for enhanced patient safety.

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Patient and Clinician Perspectives on Collaborative Work in the Emergency Department

Wust,

Barton,

Werner

et al. 2023

Springer Series in Design and Innovation

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Disparate perspectives: Exploring healthcare professionals' misaligned mental models of older adults’ transitions of care between the emergency department and skilled nursing facility

Cited by 6 publications

References 46 publications

Older Adult Patients and Care Partners as Knowledge Brokers in Fragmented Health Care

Older Adult Patients and Care Partners as Knowledge Brokers in Fragmented Health Care

Patient Safety Learning Labs: Effective Collaborations for Enhanced Patient Safety

Patient and Clinician Perspectives on Collaborative Work in the Emergency Department

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