Communication, Perception, and Other Factors Complicate Care Transitions

November 3, 2017 | Aging Services Risk, Quality, & Safety Guidance

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​Four factors play a role in making effective care transitions difficult: increasingly complex patient conditions; disparity between real and perceived facility capabilities; financial pressures; and communication barriers. Researchers conducted a survey of 25 hospitals and 16 skilled nursing facilities and identified these common themes among the responses. Their findings are published in the November 2017 issue of The Joint Commission Journal on Quality and Patient Safety. For each of the four themes identified, researchers noted the difference in perspective between hospital care providers and skilled nursing care providers. For example, regarding the first theme—increased complexity of patient conditions—hospital providers note that patients are constantly "teetering" on the edge of requiring hospitalization, while skilled nursing care providers perceive that regarding hospital discharge, "people are coming out quicker. They're coming out sicker." Likewise, in selecting the optimal care setting to discharge a patient to, hospital providers note that it's "much easier" to discharge a patient to a facility than to home, while skilled nursing providers note that they lack the staff and support that hospitals enjoy.

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