Unit of Academic Primary Care, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK.
Unit of Academic Primary Care, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK.
Patient Educ Couns. 2021 Jul;104(7):1681-1703. doi: 10.1016/j.pec.2020.12.010. Epub 2020 Dec 23.
Transitions from hospital to home are high-risk episodes. Communication problems between patients/carers and their primary healthcare providers are a central part of the risk. This literature review aimed to identify any existing tools or information (including secondary care instruments) that would facilitate designing new communication instruments for primary care to manage and mitigate risk at discharge.
Five databases (Pubmed, Embase, Cinahl, Web of Science and Cochrane) were searched using a three stem approach (primary/transitional care, discharge period, communication). A dual reviewer system was used, following PRISMA guidelines.
From 61 full text articles a total of ten tools were found, 25 articles contained other useful content, 19 further tools were found in grey literature. Most material originated from the USA and described hospital-based transitional care interventions.
No ready-made patient/provider communication tool for the post-discharge period in primary care was found. Future communication tools should enhance education and engagement of patients so they feel able to initiate communication.
Collating post-discharge communication material is of importance to improving the safety of care transitions and will enable creation of new tools specifically designed for primary care. These tools will improve patient activation ('the knowledge, skills and confidence a person has in managing their own health and care') with the ultimate aim of reducing error and harm in primary care through improved communication of healthcare decisions.
医院到家庭的过渡是高风险时期。患者/照顾者及其初级保健提供者之间的沟通问题是风险的核心部分。本文献综述旨在确定任何现有的工具或信息(包括二级保健工具),以促进为初级保健设计新的沟通工具,以管理和减轻出院时的风险。
使用三词法(初级/过渡护理、出院期、沟通)对五个数据库(Pubmed、Embase、Cinahl、Web of Science 和 Cochrane)进行了搜索。采用双重审查员制度,遵循 PRISMA 指南。
从 61 篇全文文章中总共找到了 10 种工具,25 篇文章包含了其他有用的内容,在灰色文献中还找到了 19 种进一步的工具。大多数材料来自美国,描述了基于医院的过渡护理干预措施。
在初级保健中没有找到用于出院后期间的现成的患者/提供者沟通工具。未来的沟通工具应加强对患者的教育和参与,使他们感到能够主动发起沟通。
整理出院后的沟通材料对于提高护理过渡的安全性非常重要,并将能够创建专门为初级保健设计的新工具。这些工具将通过改善医疗保健决策的沟通,提高患者的激活程度(“一个人管理自己的健康和护理所需的知识、技能和信心”),最终目标是减少初级保健中的错误和伤害。