Jones Kayla C, Austad Kirsten, Silver Santana, Cordova-Ramos Erika G, Fantasia Kathryn L, Perez Daisy C, Kremer Kristen, Wilson Sophie, Walkey Allan, Drainoni Mari-Lynn
Evans Center for Implementation & Improvement Sciences (CIIS), Department of Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA.
Department of Family Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA.
J Patient Exp. 2023 May 2;10:23743735231171564. doi: 10.1177/23743735231171564. eCollection 2023.
Care transitions after hospitalization require communication across care teams, patients, and caregivers. As part of a quality improvement initiative, we conducted qualitative interviews with a diverse group of 53 patients who were recently discharged from a hospitalization within a safety net hospital to explore how patient preferences were included in the hospital discharge process and differences in the hospital discharge experience by race/ethnicity. Four themes emerged from participants regarding desired characteristics of interactions with the discharge team: (1) to feel heard, (2) inclusion in decision-making, (3) to be adequately prepared to care for themselves at home through bedside teaching, (4) and to have a clear and updated discharge timeline. Additionally, participants identified patient-level factors the discharge planning team should consider, including the social context, family involvement, health literacy, and linguistic barriers. Lastly, participants identified provider characteristics, such as a caring and empathetic bedside manner, that they found valuable in the discharge process. Our findings highlight the need for shared decision-making in the discharge planning process to improve both patient safety and satisfaction.
住院后的护理过渡需要跨护理团队、患者和护理人员进行沟通。作为质量改进计划的一部分,我们对53名近期在安全网医院出院的不同患者进行了定性访谈,以探讨患者的偏好如何纳入医院出院流程,以及不同种族/族裔在医院出院体验上的差异。参与者就与出院团队互动的期望特征提出了四个主题:(1)被倾听,(2)参与决策,(3)通过床边教学为在家自理做好充分准备,(4)有明确且更新的出院时间表。此外,参与者指出了出院计划团队应考虑的患者层面因素,包括社会背景、家庭参与、健康素养和语言障碍。最后,参与者确定了他们在出院过程中认为有价值的医护人员特征,比如关怀和共情的床边态度。我们的研究结果强调了在出院计划过程中进行共同决策以提高患者安全性和满意度的必要性。