Transitions of care for older adults discharged home from the emergency department: an inductive thematic content analysis of patient comments

被引：2

作者：

Couture, Vanessa ^{[1
]}

Germain, Nathalie ^{[1
,2
]}

Cote, Emilie ^{[1
]}

Lavoie, Lise ^{[1
]}

Robitaille, Joanie ^{[1
]}

Morin, Michele ^{[1
,2
]}

Chouinard, Josee ^{[1
]}

Couturier, Yves ^{[3
]}

Legare, France ^{[2
,4
,5
,6
]}

Hardy, Marie-Soleil ^{[1
]}

Chartier, Lucas B. ^{[7
]}

Brousseau, Audrey-Anne ^{[8
]}

Sourial, Nadia ^{[9
]}

Mercier, Eric ^{[2
,6
]}

Dallaire, Clemence ^{[1
,10
]}

Fleet, Richard ^{[1
,2
,4
]}

Leblanc, Annie ^{[1
,2
,4
]}

Melady, Don ^{[11
,12
]}

Roy, Denis ^{[13
]}

Sinha, Samir ^{[11
,14
,15
,16
]}

Sirois, Marie-Josee ^{[2
,17
]}

Witteman, Holly O. ^{[2
,4
]}

Emond, Marcel ^{[2
,4
,5
]}

Rivard, Josee ^{[1
]}

Pelletier, Isabelle ^{[1
]}

Turcotte, Stephane ^{[1
]}

Samb, Rawane ^{[1
]}

Giguere, Raphaelle ^{[1
,18
]}

Abrougui, Lyna ^{[1
,18
]}

Smith, Pascal Y. ^{[1
]}

Archambault, Patrick M. ^{[1
,2
,4
,5
]}

机构：

[1] Ctr Integre Sante & Serv Sociaux Chaudiere Appala, Ctr Rech Integree Syst Apprenant Sante & Serv Soc, Levis, PQ, Canada

[2] Univ Laval, Fac Med, Quebec City, PQ, Canada

[3] Univ Sherbrooke, Dept Social Work, Sherbrooke, PQ, Canada

[4] VITAM Ctr Rech Sante Durable, Quebec City, PQ, Canada

[5] Univ Laval, Dept Family Med & Emergency Med, Quebec City, PQ, Canada

[6] Univ Laval, CHU Quebec, Ctr Rech, Axe Sante Populat & Prat Optimales Sante, Quebec City, PQ, Canada

[7] Univ Hlth Network, Dept Emergency Med, Toronto, ON, Canada

[8] Univ Sherbrooke, Dept Family Med, Sherbrooke, PQ, Canada

[9] Univ Montreal, Sch Publ Hlth, Dept Hlth Management Evaluat & Policy, Montreal, PQ, Canada

[10] Univ Laval, Fac Nursing Sci, Quebec City, PQ, Canada

[11] Univ Toronto, Dept Family & Community Med, Toronto, ON, Canada

[12] Mt Sinai Hosp, Schwartz Reisman Emergency Med Inst, Toronto, ON, Canada

[13] CSBE, Quebec City, PQ, Canada

[14] Univ Toronto, Dept Med, Toronto, ON, Canada

[15] Sinai Hlth Syst, Dept Med, Toronto, ON, Canada

[16] Univ Hlth Network, Toronto, ON, Canada

[17] Univ Laval, Fac Med, Dept Readaptat, Quebec City, PQ, Canada

[18] Univ Laval, Fac Sci & Engn, Quebec City, PQ, Canada

[19] Network Canadian Emergency Researchers, Ottawa, ON, Canada

来源：

BMC GERIATRICS | 2024年 / 24卷 / 01期

基金：

加拿大健康研究院;

关键词：

Emergency department; Care transitions; Patient experience; Aging; COVID-19; Geriatrics; CONTROLLED-TRIAL; AFTER-DISCHARGE; OUTCOMES; QUALITY; INTERVENTIONS; ASSOCIATION; PROGRAM; ELDERS;

D O I：

10.1186/s12877-023-04482-0

中图分类号：

R592 [老年病学]; C [社会科学总论];

学科分类号：

03 ; 0303 ; 100203 ;

摘要：

ObjectiveImproving care transitions for older adults can reduce emergency department (ED) visits, adverse events, and empower community autonomy. We conducted an inductive qualitative content analysis to identify themes emerging from comments to better understand ED care transitions.MethodsThe LEARNING WISDOM prospective longitudinal observational cohort includes older adults (>= 65 years) who experienced a care transition after an ED visit from both before and during COVID-19. Their comments on this transition were collected via phone interview and transcribed. We conducted an inductive qualitative content analysis with randomly selected comments until saturation. Themes that arose from comments were coded and organized into frequencies and proportions. We followed the Standards for Reporting Qualitative Research (SRQR).ResultsComments from 690 patients (339 pre-COVID, 351 during COVID) composed of 351 women (50.9%) and 339 men (49.1%) were analyzed. Patients were satisfied with acute emergency care, and the proportion of patients with positive acute care experiences increased with the COVID-19 pandemic. Negative patient comments were most often related to communication between health providers across the care continuum and the professionalism of personnel in the ED. Comments concerning home care became more neutral with the COVID-19 pandemic.ConclusionPatients were satisfied overall with acute care but reported gaps in professionalism and follow-up communication between providers. Comments may have changed in tone from positive to neutral regarding home care over the COVID-19 pandemic due to service slowdowns. Addressing these concerns may improve the quality of care transitions and provide future pandemic mitigation strategies.

引用

页数：17

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