TY - JOUR
T1 - Patient Perspective on Care Transitions after Colorectal Surgery
AU - Kelly, Kristin N.
AU - Noyes, Katia
AU - Dolan, James
AU - Fleming, Fergal
AU - Monson, John RT.
AU - Gonzalez, Maynor
AU - Sevdalis, Nick
AU - Dozier, Ann
PY - 2016/2/18
Y1 - 2016/2/18
N2 - 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.
AB - 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.
KW - colorectal
KW - hospital discharge
KW - qualitative research
KW - patient perspective
KW - informal caregiver
KW - communication
U2 - 10.1016/j.jss.2016.02.011
DO - 10.1016/j.jss.2016.02.011
M3 - Article
SN - 0022-4804
JO - Journal of Surgical Research
JF - Journal of Surgical Research
ER -