TY - JOUR
AU - Crick, M
AB - Objectives Older adults with multiple chronic conditions typically have more complex needs, and often seek care across different sectors. These older adults may also have multiple care transitions during their health care journey. Poor care transitions often lead to fragmentation in care, decreased quality of care, and an increase in adverse events. Emerging research recommends the strong need to engage patients and families to improve the quality of their care. The objectives of this study were to: (1) describe the experience of older adults with multiple chronic conditions and their caregivers during transitions of care; (2) explore the strategies that patients and their caregivers currently use to navigate their care transition experiences; (3) understand the aspects of their care transitions that patients and their caregivers attribute with safety and quality problems; and (4) understand the aspects of care transitions that patients and their caregivers attribute to improving the safety and quality of their experiences. Methods This study used participatory visual methods informed by a socio-ecological perspective. Sampling and recruitment We used both purposive and theoretical sampling. The inclusion criteria were: patients managing at least one chronic condition; patients receiving primary care services for greater than 90 days; patients who experienced at least one transfer across sectors within the past 90 days; men and women aged 50 years or older; and patients who were legally competent. Family members at least 18 years of age or older were also invited to participate. Data collection tools and methods We conducted 60 to 90-minute audio-recorded photo walkabout sessions in the patients’ home. Immediately following the photo walkabouts, further discussions with patients/families took place to collect further data about their experiences. Ethical approval was obtained from the local Research Ethics Board. Data analysis Two individuals independently reviewed and coded each transcript. The data was then analyzed for similarities across the transcripts using an iterative process until consensus on the coding and analysis was reached. ATLAS.ti (SSD GmBH, Berlin) was used to manage the visual and textual data and supported the thematic analysis of the photo walkabout narratives and photo elicitation table top discussions. Results We conducted a total of nine photo walkabouts between February and September 2016. Overall, patients and families identified the importance of active involvement in managing their own care transitions; described their positive experiences during care transitions; described their successes with accessing community services and resources; as well as their challenges with accessing these services and resources; shared insights into how they felt a lack of meaningful engagement during discharge planning; and identified some systemic barriers during care transitions. Conclusion Based on patient and family members, the study identified three main recommendations specific to older adults managing chronic conditions during care transitions for policy makers, care providers, patient and families to collaboratively implement. Disclosure of Interest C. Backman Grant / Research support from: The Beryl Institute, M. Crick: None Declared. © The Author 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com © The Author 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com
TI - ISQUA17-1430THE VOICE STUDY: EMBEDDING THE PATIENT VOICE OF OLDER ADULTS IN THE EXPLORATION OF THEIR EXPERIENCES DURING CARE TRANSITIONS
JF - International Journal for Quality in Health Care
DO - 10.1093/intqhc/mzx125.50
DA - 2017-09-01
UR - https://www.deepdyve.com/lp/oxford-university-press/isqua17-1430the-voice-study-embedding-the-patient-voice-of-older-GO0I0RTIr0
SP - 32
EP - 33
VL - 29
IS - suppl_1
DP - DeepDyve
ER -