BACKGROUND: Reducing hospital readmissions depends on ensuring safe care transitions, which requires a better understanding of the challenges experienced by key stakeholders. OBJECTIVE: Develop a descriptive framework illustrating the interconnected roles of patients, providers, and caregivers in relation to readmissions. DESIGN: Multimethod qualitative study with 4 focus groups and 43 semistructured interviews. Multiple perspectives were included to increase the trustworthiness (internal validity) and transferability (external validity) of the results. Data were analyzed using grounded theory to generate themes associated with readmission. SETTING/PATIENTS: General medicine patients with same-site 30-day readmissions, their family members, and multiple care providers at a large urban academic medical center. RESULTS: A keynote generated from the multiperspective responses was that care transitions were optimized by a well-coordinated multidiscipline support system, described as the Patient Care Circle. In addition, issues pertaining to readmissions were identified and classified into 5 main themes emphasizing the necessity of a coordinated support network: (1) teamwork, (2) health systems navigation and management, (3) illness severity and health needs, (4) psychosocial stability, and (5) medications. CONCLUSION: A well-coordinated collaborative Patient Care Circle is fundamental to ensuring safe care transitions.
BACKGROUND: Reducing hospital readmissions depends on ensuring safe care transitions, which requires a better understanding of the challenges experienced by key stakeholders. OBJECTIVE: Develop a descriptive framework illustrating the interconnected roles of patients, providers, and caregivers in relation to readmissions. DESIGN: Multimethod qualitative study with 4 focus groups and 43 semistructured interviews. Multiple perspectives were included to increase the trustworthiness (internal validity) and transferability (external validity) of the results. Data were analyzed using grounded theory to generate themes associated with readmission. SETTING/PATIENTS: General medicine patients with same-site 30-day readmissions, their family members, and multiple care providers at a large urban academic medical center. RESULTS: A keynote generated from the multiperspective responses was that care transitions were optimized by a well-coordinated multidiscipline support system, described as the Patient Care Circle. In addition, issues pertaining to readmissions were identified and classified into 5 main themes emphasizing the necessity of a coordinated support network: (1) teamwork, (2) health systems navigation and management, (3) illness severity and health needs, (4) psychosocial stability, and (5) medications. CONCLUSION: A well-coordinated collaborative Patient Care Circle is fundamental to ensuring safe care transitions.
Authors: Paul Feigenbaum; Estee Neuwirth; Linda Trowbridge; Serge Teplitsky; Carol Ann Barnes; Emily Fireman; Jann Dorman; Jim Bellows Journal: Med Care Date: 2012-07 Impact factor: 2.983
Authors: Melinda M Davis; Meg Devoe; Devan Kansagara; Christina Nicolaidis; Honora Englander Journal: J Gen Intern Med Date: 2012-07-25 Impact factor: 5.128
Authors: Shreya Kangovi; David Grande; Patricia Meehan; Nandita Mitra; Richard Shannon; Judith A Long Journal: J Hosp Med Date: 2012-08-07 Impact factor: 2.960
Authors: Vincenza Snow; Dennis Beck; Tina Budnitz; Doriane C Miller; Jane Potter; Robert L Wears; Kevin B Weiss; Mark V Williams Journal: J Gen Intern Med Date: 2009-04-03 Impact factor: 5.128