Hospital to home care transitions:

    Item Description
    A quality improvement initiative
    Linked Agent
    Thesis advisor: Karg, Pamela S.
    Committee member: Lewis, Deborah
    Committee member: Best, Melanie C.
    Degree granting institution: Pennsylvania Western University
    Department: Nursing
    Date Created
    2023
    Date Issued
    2023
    Abstract
    In hospitalized patients, the transition from hospital to home can lead to adverse events, negative outcomes, ER visits, and hospital readmissions (Backman et al., 2021). A poor transition of care can also be reflected in low Care Transition scores in HCAHPS surveys. The Care Transition questions reflect how well the patient felt prepared to manage their own care at home.

    This quality improvement initiative answered the following research question: “In hospitalized adult patients, how does collaborative care transition planning compared with traditional discharge planning affect Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores one month after implementation”?

    The theoretical framework is Larrabee’s model of Evidence-Based Practice. Methods include comparing the Care Transitions scores the month prior to implementation to those from the month following implementation.

    There was a decrease in scores the month during implementation, but then increased in the month after. While not a part of the initial data collection, there was also an improvement in patients’ average length of stay. It can be concluded that the increase in communication amongst the healthcare team during the huddle did play a part in the efficiency of managing patients’ plan of care.

    The nursing implications include the need for increased communication. When the healthcare team works together, it improves the patients’ transition from hospital to home. Future research may focus on length of stay as an important variable. A limitation of this study was a lack of consistency in collaborative rounding. Additional research in this area is needed.
    Resource Type
    Place Published
    California, Pa
    Language
    Extent
    pdf
    40 pages
    552 KB
    Physical Form
    Rights
    Gibson, Stacy. Hospital to home care transitions: A quality improvement initiative. California, PA: Pennsylvania Western University, 2023. Accessed from Pennsylvania Western University Archives.
    Institution