Searching for the missing pieces between the hospital and primary care: mapping the patient process during care transitionsстатья из журнала
Аннотация: Background 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. Objective Our aim was to demonstrate how process mapping can illustrate current handover practices between ambulatory and inpatient care settings, identify existing barriers and facilitators to effective transitions of care, and highlight potential areas for quality improvement. Methods We conducted focus group interviews to facilitate a process mapping exercise with clinical teams in six academic health centres in the USA, Poland, Sweden, Italy, Spain and the Netherlands. Findings At a high level, the process of patient admission to the hospital through the emergency department, inpatient care, and discharge back in the community were comparable across sites. In addition, the process maps highlighted similar barriers to providing information to primary care physicians, inaccurate or incomplete information on referral and discharge, a lack of time and priority to collaborate with counterpart colleagues, and a lack of feedback to clinicians involved in the handovers. Conclusions 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.
Год издания: 2012
Авторы: Julie K. Johnson, Jeanne M. Farnan, Paul Barach, Gijs Hesselink, Hub Wollersheim, L Pijnenborg, Cor J. Kalkman, Vineet M. Arora
Издательство: BMJ
Источник: BMJ Quality & Safety
Ключевые слова: Hospital Admissions and Outcomes, Primary Care and Health Outcomes, Healthcare Policy and Management
Другие ссылки: BMJ Quality & Safety (PDF)
BMJ Quality & Safety (HTML)
Notes and Queries (PDF)
Notes and Queries (HTML)
PubMed (HTML)
BMJ Quality & Safety (HTML)
Notes and Queries (PDF)
Notes and Queries (HTML)
PubMed (HTML)
Открытый доступ: hybrid
Том: 21
Выпуск: Suppl 1
Страницы: i97–i105