Solh Dost Léa, Maillard Gaëlle, Cardoso Evelina, Schneider Marie P
School of Pharmaceutical Sciences, University of Geneva, Genève, Switzerland.
Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, Genève, Switzerland.
J Multidiscip Healthc. 2025 Jul 30;18:4453-4467. doi: 10.2147/JMDH.S528819. eCollection 2025.
Poor coordination and communication during care transitions can lead to medical errors, patient dissatisfaction, and hospital readmissions. The transition period from hospital to the first medical appointment is a high-risk and vulnerable time for patients, and a complex one for healthcare professionals. While interprofessional collaboration can improve the quality and safety of care, its implementation remains underexplored. This study examines the current state and areas for improvement in interprofessional medication management during the hospital discharge transition (from hospital discharge to first medical appointment) for patients self-managing their medications.
A qualitative study was conducted using a serial focus group methodology with patients and healthcare professionals from hospital and community settings. Participants were sampled purposively. Discussions were audio-recorded, transcribed verbatim, and analysed using inductive thematic analysis. Thematic findings were categorised using the 2010 Canadian National Interprofessional Competency (CIHC) Framework, distinguishing between current practices and areas for improvement. Additionally, a classification questionnaire, adapted from the nominal group technique, was used to rank proposed improvement strategies based on their perceived impact and feasibility.
Twelve participants (10 healthcare professionals and two patients) contributed to four focus groups. The study identified strengths and areas for improvement in five of the six CIHC 2010 competency domains: 1. Interprofessional communication: present but needing better structure and proactivity; 2. Patient partnership: recognised but requiring more consistency; 3. Role clarification: unclearly defined, causing inefficiencies; 4. Team functioning: common in hospital settings, but inconsistent during transition; 5. Collaborative leadership: present but lacking clear coordination at handover. An overarching category, "Macro-level improvements" was introduced to highlight system-wide changes and the need for policy support to implement and sustain interprofessional collaboration.
While existing practices emphasise interprofessional communication and patient involvement, role clarity and collaborative leadership remain significant challenges. Healthcare professionals are motivated and ready to collaborate, but policy and coordinated efforts among healthcare meso- and macro-entities are needed to implement sustainable interprofessional practice models, to increase quality of pharmaceutical care, and improve patient outcomes during care transition from hospital to home.
护理转接过程中协调与沟通不善可能导致医疗差错、患者不满以及再次入院。从医院到首次就诊的过渡阶段对患者来说是高风险且易受伤害的时期，对医疗保健专业人员而言也是复杂的时期。虽然跨专业协作能够提高护理质量和安全性，但其实施情况仍有待深入探究。本研究考察了患者自行管理药物情况下，医院出院转接（从出院到首次就诊）过程中跨专业药物管理的现状及改进领域。
采用系列焦点小组方法，对来自医院和社区环境的患者及医疗保健专业人员开展了一项定性研究。参与者通过目的抽样选取。讨论进行了录音，逐字转录，并采用归纳主题分析法进行分析。主题研究结果依据2010年加拿大国家跨专业能力（CIHC）框架进行分类，区分当前实践与改进领域。此外，一份改编自名义群体技术的分类问卷用于根据所感知的影响和可行性对提出的改进策略进行排序。
12名参与者（10名医疗保健专业人员和2名患者）参与了4个焦点小组。该研究确定了2010年CIHC六个能力领域中五个领域的优势及改进领域：1. 跨专业沟通：存在但需要更好的结构和主动性；2. 患者伙伴关系：得到认可但需要更多一致性；3. 角色澄清：定义不明确，导致效率低下；4. 团队运作：在医院环境中常见，但转接过程中不一致；5. 协作领导：存在但交接时缺乏明确协调。引入了一个总体类别“宏观层面改进”，以突出全系统变革以及实施和维持跨专业协作所需的政策支持。
虽然现有实践强调跨专业沟通和患者参与，但角色清晰度和协作领导仍然是重大挑战。医疗保健专业人员有积极性且准备好进行协作，但需要医疗保健中观和宏观实体之间的政策及协调努力，以实施可持续的跨专业实践模式，提高药学护理质量，并改善从医院到家庭的护理转接过程中的患者结局。
