BMJ quality & safety
-
BMJ quality & safety · Dec 2012
Multicenter StudySearching for the missing pieces between the hospital and primary care: mapping the patient process during care transitions.
Safe patient transitions depend on effective communication and a functioning care coordination process. Evidence suggests that primary care physicians are not satisfied with communication at transition points between inpatient and ambulatory care, and that communication often is not provided in a timely manner, omits essential information, or contains ambiguities that put patients at risk. ⋯ Process mapping is effective in bringing together key stakeholders and makes explicit the mental models that frame their understanding of the clinical process. Exploring the barriers and facilitators to safe and reliable patient transitions highlights opportunities for further improvement work and illustrates ideas for best practices that might be transferrable to other settings.
-
BMJ quality & safety · Dec 2012
Multicenter StudyAre patients discharged with care? A qualitative study of perceptions and experiences of patients, family members and care providers.
Advocates for quality and safety have called for healthcare that is patient-centred and decision-making that involves patients. ⋯ Our findings suggest that involvement of patients and families in the preparations for discharge is determined by the extent to which care providers are willing and able to accommodate patients' and families' capabilities, needs and preferences. Future interventions should be directed at healthcare providers' attitudes and their organisation's leadership, with a focus on improving communication among care providers, patients and families, and between hospital and community care providers.
-
BMJ quality & safety · Dec 2012
Multicenter Study"It's like two worlds apart": an analysis of vulnerable patient handover practices at discharge from hospital.
Handover practices at hospital discharge are relatively under-researched, particularly as regards the specific risks and additional requirements for handovers involving vulnerable patients with limited language, cognitive and social resources. ⋯ Discharge handovers are often haphazard. Healthcare professionals do not consider current handover practices safe, with patients expected to transfer information without being empowered to understand and act on it. This can lead to misinformation, omission or duplication of tests or interventions and, potentially, patient harm. Vulnerable patients may be at greater risk given their limited language, cognitive and social resources. Patient safety at discharge could benefit from strategies to enhance patient education and promote empowerment.