Patient Perspective on Care Transitions after Colorectal Surgery

Kristin N. Kelly, Katia Noyes, James Dolan, Fergal Fleming, John RT. Monson, Maynor Gonzalez, Nick Sevdalis, Ann Dozier

Research output: Contribution to journalArticlepeer-review

11 Citations (Scopus)
372 Downloads (Pure)

Abstract

AbstractBackground The surgical care pathway is characterized by multiple transitions, from pre-operative assessment to in-patient stay, discharge from hospital and follow-up care. Breakdowns in one phase can affect subsequent phases, which in turn can cause delays, cancellations, and complications. Efforts to improve care transitions focused primarily on post-discharge care coordination and inpatient education for medically complex patients have not demonstrated consistent effects. This study aimed to understand the expectations and perceptions of postoperative inpatients regarding transition from hospital to home in an effort to reduce patient burden. Materials and Methods Patients who underwent a colorectal resection at a large academic medical center and were discharged home were eligible to participate in the study. Patients were recruited during their postoperative hospital stays and interviewed over the phone within a week after discharge about their perceptions of care, values, and attitudes. Overall, we recruited 16 patients with benign (n=8) and malignant (n=8) indications. Recruitment continued until theme saturation. Results Factors that shaped patients' understanding of post-surgical recovery and that motivated them to seek provider attention post-discharge fell into three major groups: patient expectations vs. reality, availability and role of informal caregivers in the postoperative recovery process, and communication as a key to patient confidence and trust. Conclusions For patients and caregivers, postoperative planning starts long before surgery and hospital admission. Providers should consider these dynamics in designing interventions to improve care transitions, patient satisfaction and long-term outcomes. This study was limited to colorectal surgical patients treated in a single institution and may be not generalizable to other surgical procedures, non-academic settings or different regions.
Original languageEnglish
JournalJournal of Surgical Research
Early online date18 Feb 2016
DOIs
Publication statusE-pub ahead of print - 18 Feb 2016

Keywords

  • colorectal
  • hospital discharge
  • qualitative research
  • patient perspective
  • informal caregiver
  • communication

Fingerprint

Dive into the research topics of 'Patient Perspective on Care Transitions after Colorectal Surgery'. Together they form a unique fingerprint.

Cite this