Effectiveness of person- and family-centered care transition interventions: a systematic review protocol

Abstract

BackgroundCare transitions from the hospital to home are critical to the sustainability of our health care system. Ineffective care transitions can be caused by high incidences of post-discharge adverse events, by poor communication with patients, and/or by inadequate information transfer between providers from the hospital to home. Any one of these can lead to fragmented care, high readmission rates, increased visits to the emergency department, and ultimately poor patient outcomes. Despite the ongoing improvement efforts of health care organizations, the efficacy of person- and family-centered care transition interventions on the quality of care and on the patient experience are not known. The aim of this systematic review is to critically analyze the body of evidence regarding the effectiveness of person- and family-centered care transition interventions on the quality of care, and the experience of patients.MethodsWe will conduct a systematic review using the Cochrane Handbook’s guidelines and will adhere to a standardized reporting format: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A comprehensive search strategy will be conducted in the following databases: MEDLINE, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials, and the Cochrane Consumers and Communication Group. Following a two-step screening process, data including the full reference, objectives, target population, description of the intervention and control intervention, outcome measures, design, length of post-intervention follow-up period, and the study results will be extracted, synthesized, and reported. Risk of bias and quality of the studies will also be assessed.DiscussionThis systematic review will summarize and present the evidence base for person- and family-centered care transition interventions. This review will also inform further research and will lay the groundwork for more empirical studies on person- and family-centered care transitions. Specifically, the results of this systematic review may inform the development of measures to monitor safe and effective person- and family-centered transitions from the hospital to home. These results may also be important for policy makers, decision-makers, clinicians, and patients/families who are involved in navigating the health care system.Systematic review registrationPROSPERO CRD42017067990 Electronic supplementary materialThe online version of this article (doi:10.1186/s13643-017-0554-z) contains supplementary material, which is available to authorized users.

Safe and effective person- and family-centered care practices during transitions from hospital to home—A web-based Delphi technique

“…This was done by grouping similar response statements, and then theming them. To identify any missing themes, the research assistant reviewed the themes against the existing relevant literature found in our recent systematic review on the effectiveness of PFCC transition interventions from hospital to home[35]. Missing themes were then added to the primary data collected during Round 1.…”

<p>Engaging patients and informal caregivers to improve safety and facilitate person- and family-centered care during transitions from hospital to home &ndash; a qualitative descriptive study</p>

“…Challenges associated with care transitions are complex and thus require a multifaceted approach and coordinated care to improve quality and health outcomes 7,8. Ensuring a high level of person- and family-centered care (PFCC) is one particularly important aspect for improving quality and health outcomes during care transitions 9–11…”

Toward developing consensus on family-centred care: An international descriptive study and discussion

“…The concept of FCC is often poorly characterized and imprecisely described, and the rigor of the research that has studied the concept has been variable (Backman et al, 2017; Kuo et al, 2012; Shields, 2011; Sidani and Fox, 2014). Without conceptual clarity, many of the claims that have been made about the benefits, or otherwise, of FCC lack a solid foundation (Carter, 2008; Uniacke et al, 2018).…”