Transitional ‘hospital to home’ care of older patients: healthcare professionals’ perspectives

Abstract

Background Transitional care is a key area of care provision to older people with chronic and complex health conditions and is associated with the quality of care delivered in the healthcare system. Aims This study aimed to explore the perspectives of healthcare providers, including nurses and physicians, regarding transitional care from hospital to home in an urban area of Turkey. Methods A qualitative study using a thematic analysis method was carried out. In‐depth semi‐structured interviews were held with eight clinical nurses and five general physicians involved in the provision of healthcare services to older patients in the transitional care process from hospital to home. Findings The thematic analysis of in‐depth semi‐structured interviews with 13 healthcare professionals led to the development of the following themes: ‘uninterrupted chain of care transfer’, ‘commitment to meet patient’s needs’ and ‘support and removing ambiguities’. Conclusions Key factors impacting on the quality and safety of transitional care and continuity of healthcare are communication and collaboration between healthcare staff and settings, and older patients’ as well as family caregivers’ awareness and their feelings of responsibility towards the continuity of care at home.

Discharge Communications for Older Patients Between Hospital Healthcare Providers and Home Healthcare Providers: An Integrative Review

“…For example, a discharge note, discharge paper, and discharge summary were used to refer to discharge documents that were provided by hospital providers to patients. 21-27 Different study settings, such as different countries, different hospitals, or different electronic hospital record vendors, may explain the use of different terms.…”

“…18 Communication during the transitional care period is especially important for older patients because it is difficult for older patients to detect or identify errors in their discharge documents by themselves compared to younger patients. 21…”

“…19,20 Therefore, the role of the healthcare providers who are involved in the transitional care process, requires supportive communication skills during the transition. 21…”

Needs Assessment of Safe Medicines Management for Older People With Cognitive Disorders in Home Care: An Integrative Systematic Review

“…Moreover, a supportive and professional family caregiver-healthcare relationship with an emphasis on considering family caregivers' concerns, their education, and empowerment to safely perform the medication process was needed. The accepted perspective is that older people with cognitive impairment living in the community need coordinated and flexible care process (60)(61)(62)). An early integration of holistic palliative care approaches that encompass medicines management initiatives into home care should be included from the beginning of the illness (63,64).…”

PRN Medicines Optimization and Nurse Education

“…If a patient is unable to take responsibility for their medication, relatives or informal caregivers can be educated and asked to manage the patient’s medication [ 61 , 62 , 63 ]. Informal and family caregivers can participate in the physical handling of PRN medication in terms of obtaining medications, preparing pillboxes or assisting with medication administration, organizing/tracking medications, collecting information and making treatment decisions [ 61 ], and educational activities as patient representatives [ 64 ]. Nevertheless, all reasonable measures should be used to encourage patients to take an active role [ 65 , 66 ].…”