Emerging lessons from experiences at transitions in care among hospitalised patients with cancer with postdischarge frequent emergency department use: a qualitative study using linked clinical and patient-reported interview data from Quebec, Canada
Background While teamwork is essential to providing high-quality patient-centred care, challenges in interprofessional collaboration and decision-making in hospital settings are common, especially for patients with cancer. The purpose of this qualitative study was to identify emerging themes and pot...
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BMJ Publishing Group
2024-10-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/14/10/e085219.full |
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| author | Robyn Tamblyn Siyana Kurteva Nabil Nassar |
| author_facet | Robyn Tamblyn Siyana Kurteva Nabil Nassar |
| author_sort | Robyn Tamblyn |
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| description | Background While teamwork is essential to providing high-quality patient-centred care, challenges in interprofessional collaboration and decision-making in hospital settings are common, especially for patients with cancer. The purpose of this qualitative study was to identify emerging themes and potential challenges related to hospital discharge experiences among patients hospitalised for cancer who became frequent emergency department (ED) users postdischarge.Methods A cohort of patients with cancer discharged from an academic health centre in Montreal (Canada) between October 2014 and November 2016 was assembled. Using health administrative claims from the provincial universal healthcare programme, frequent ED (FED) users were identified as patients who had a ≥4 ED visits in the year following hospital discharge. Qualitative analysis of transcripts from semistructured telephone interviews conducted with patients 25–30 days’ postdischarge was used for in-depth exploratory analyses to characterise hospital discharge experiences and transition process from the hospital to the community.Results Overall, 182 (14.5%) of 1253 patients with cancer who became FED users were included in this study. The mean age was 69.1 (SD=11.5), 59.9% (n=109) were male, and the most frequent cancers were 80 (43.9%) respiratory and 52 (28.6%) upper digestive cancer. Content analyses revealed six emerging themes from the FED patient interviews. Overall, these included (1) incomplete communication of information, (2) hospital discharge planning, (3) coordinating care among team members, (4) follow-up with outpatient providers, (5) monitoring and managing symptoms after discharge and (6) enlisting help of social and community supports.Conclusions Using integrated data from clinical, administrative claims and patient interviews, this study provided insights into the challenges related to hospital discharge experiences and transition into community among hospitalised patients with cancer with FED use. Application of our findings could assist in hospital discharge preparation and improvement in healthcare delivery and health outcomes.Trial registration number NCT01179867. |
| format | Article |
| id | doaj-art-e8ed4b1e8ff349598b57a4c15dffbd44 |
| institution | OA Journals |
| issn | 2044-6055 |
| language | English |
| publishDate | 2024-10-01 |
| publisher | BMJ Publishing Group |
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| series | BMJ Open |
| spelling | doaj-art-e8ed4b1e8ff349598b57a4c15dffbd442025-08-20T02:09:47ZengBMJ Publishing GroupBMJ Open2044-60552024-10-01141010.1136/bmjopen-2024-085219Emerging lessons from experiences at transitions in care among hospitalised patients with cancer with postdischarge frequent emergency department use: a qualitative study using linked clinical and patient-reported interview data from Quebec, CanadaRobyn Tamblyn0Siyana Kurteva1Nabil Nassar2McGill University, Montreal, Québec, CanadaEpidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada2 Department of Epidemiology and Biostatistics, McGill University Montreal, Montreal, CanadaBackground While teamwork is essential to providing high-quality patient-centred care, challenges in interprofessional collaboration and decision-making in hospital settings are common, especially for patients with cancer. The purpose of this qualitative study was to identify emerging themes and potential challenges related to hospital discharge experiences among patients hospitalised for cancer who became frequent emergency department (ED) users postdischarge.Methods A cohort of patients with cancer discharged from an academic health centre in Montreal (Canada) between October 2014 and November 2016 was assembled. Using health administrative claims from the provincial universal healthcare programme, frequent ED (FED) users were identified as patients who had a ≥4 ED visits in the year following hospital discharge. Qualitative analysis of transcripts from semistructured telephone interviews conducted with patients 25–30 days’ postdischarge was used for in-depth exploratory analyses to characterise hospital discharge experiences and transition process from the hospital to the community.Results Overall, 182 (14.5%) of 1253 patients with cancer who became FED users were included in this study. The mean age was 69.1 (SD=11.5), 59.9% (n=109) were male, and the most frequent cancers were 80 (43.9%) respiratory and 52 (28.6%) upper digestive cancer. Content analyses revealed six emerging themes from the FED patient interviews. Overall, these included (1) incomplete communication of information, (2) hospital discharge planning, (3) coordinating care among team members, (4) follow-up with outpatient providers, (5) monitoring and managing symptoms after discharge and (6) enlisting help of social and community supports.Conclusions Using integrated data from clinical, administrative claims and patient interviews, this study provided insights into the challenges related to hospital discharge experiences and transition into community among hospitalised patients with cancer with FED use. Application of our findings could assist in hospital discharge preparation and improvement in healthcare delivery and health outcomes.Trial registration number NCT01179867.https://bmjopen.bmj.com/content/14/10/e085219.full |
| spellingShingle | Robyn Tamblyn Siyana Kurteva Nabil Nassar Emerging lessons from experiences at transitions in care among hospitalised patients with cancer with postdischarge frequent emergency department use: a qualitative study using linked clinical and patient-reported interview data from Quebec, Canada BMJ Open |
| title | Emerging lessons from experiences at transitions in care among hospitalised patients with cancer with postdischarge frequent emergency department use: a qualitative study using linked clinical and patient-reported interview data from Quebec, Canada |
| title_full | Emerging lessons from experiences at transitions in care among hospitalised patients with cancer with postdischarge frequent emergency department use: a qualitative study using linked clinical and patient-reported interview data from Quebec, Canada |
| title_fullStr | Emerging lessons from experiences at transitions in care among hospitalised patients with cancer with postdischarge frequent emergency department use: a qualitative study using linked clinical and patient-reported interview data from Quebec, Canada |
| title_full_unstemmed | Emerging lessons from experiences at transitions in care among hospitalised patients with cancer with postdischarge frequent emergency department use: a qualitative study using linked clinical and patient-reported interview data from Quebec, Canada |
| title_short | Emerging lessons from experiences at transitions in care among hospitalised patients with cancer with postdischarge frequent emergency department use: a qualitative study using linked clinical and patient-reported interview data from Quebec, Canada |
| title_sort | emerging lessons from experiences at transitions in care among hospitalised patients with cancer with postdischarge frequent emergency department use a qualitative study using linked clinical and patient reported interview data from quebec canada |
| url | https://bmjopen.bmj.com/content/14/10/e085219.full |
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