Safe and effective person- and family-centered care practices during transitions from hospital to home-A web-based Delphi technique

Chantal Backman; Sharon Johnston; Nelly D Oelke; Katharina Kovacs Burns; Linda Hughes; Wendy Gifford; Jeanie Lacroix; Alan J Forster

doi:10.1371/journal.pone.0211024

Safe and effective person- and family-centered care practices during transitions from hospital to home-A web-based Delphi technique

PLoS One. 2019 Jan 22;14(1):e0211024. doi: 10.1371/journal.pone.0211024. eCollection 2019.

Authors

Chantal Backman^{1

2

3}, Sharon Johnston^{3

4}, Nelly D Oelke⁵, Katharina Kovacs Burns^{6

7}, Linda Hughes⁶, Wendy Gifford¹, Jeanie Lacroix⁸, Alan J Forster^{2

4}

Affiliations

¹ School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada.
² Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada.
³ Bruyère Research Institute, Ottawa, Canada.
⁴ Faculty of Medicine, University of Ottawa, Ottawa, Canada.
⁵ School of Nursing, Faculty of Health and Social Development, University of British Columbia, Kelowna, Canada.
⁶ Patients for Patient Safety Canada, Edmonton, Canada.
⁷ School of Public Health, University of Alberta, Edmonton, Canada.
⁸ Canadian Institute for Health Information, Toronto, Canada.

Abstract

Background: Research has shown that adverse events during care transitions from hospital to home can have a significant impact on patients' outcomes, leading to readmission, delayed healing or even death. Gaps exist in the ways of monitoring care during transition periods and there is a need to help organizations better implement and monitor safe person-and family-centered care. Value statements are a way to obtain narratives in lay terms about how well care, treatment and support is organized to meet the needs and preferences of patients/families. The purpose of this study was to identify the value statements that are perceived by decision-makers and patients/families to best signify safe person- and family-centered care during transitions from hospital to home.

Methods: Between January and September 2017, a web-based Delphi was used to survey key stakeholders in acute care and home care organizations across Canada.

Results: Decision-makers (n = 22) and patients/families (n = 24) from five provinces participated in the Delphi. Following Round 1, 45 perceived value statements were identified. In Round 2, consensus was received on 33/45 (73.3%) by decision-makers, and 30/45 (66.7%) by patients/families. In Round 3, additional value statements reached consensus in the decision-makers' survey (3) and in the patients/families' survey (2). A total of 30 high priority value statements achieved consensus derived from both the decision-makers' and patients/families' perspectives.

Conclusion: This study was an important first step in identifying key consensus-based priority value statements for monitoring care transitions from the perspective of both decision-makers and patients/families. Future research is needed to test their usability and to determine whether these value statements are actually suggestive of safe person-and family-centered care transition interventions from hospital to home.

Publication types

Clinical Trial
Multicenter Study
Research Support, Non-U.S. Gov't

MeSH terms

Canada
Decision Making
Delphi Technique*
Female
Hospitals*
Humans
Internet*
Male
Patient Readmission*
Patient Transfer*
Patient-Centered Care*

Grants and funding

We would like to thank the Canadian Patient Safety Institute, Accreditation Canada, the Canadian Home Care Association, Patients for Patient Safety Canada, and the Registered Nurses’ Association of Ontario for financially supporting this study. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.