Transitions of care for older adults discharged home from the emergency department: an inductive thematic content analysis of patient comments
Abstract Objective Improving care transitions for older adults can reduce emergency department (ED) visits, adverse events, and empower community autonomy. We conducted an inductive qualitative content analysis to identify themes emerging from comments to better understand ED care transitions. Metho...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2024-01-01
|
| Series: | BMC Geriatrics |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12877-023-04482-0 |
| _version_ | 1797362906187169792 |
|---|---|
| author | Vanessa Couture Nathalie Germain Émilie Côté Lise Lavoie Joanie Robitaille Michèle Morin Josée Chouinard Yves Couturier France Légaré Marie-Soleil Hardy Lucas B. Chartier Audrey-Anne Brousseau Nadia Sourial Éric Mercier Clémence Dallaire Richard Fleet Annie Leblanc Don Melady Denis Roy Samir Sinha Marie-Josée Sirois Holly O. Witteman Marcel Émond Josée Rivard Isabelle Pelletier Stéphane Turcotte Rawane Samb Raphaëlle Giguère Lyna Abrougui Pascal Y. Smith Patrick M. Archambault on behalf of the Network of Canadian Emergency Researchers |
| author_facet | Vanessa Couture Nathalie Germain Émilie Côté Lise Lavoie Joanie Robitaille Michèle Morin Josée Chouinard Yves Couturier France Légaré Marie-Soleil Hardy Lucas B. Chartier Audrey-Anne Brousseau Nadia Sourial Éric Mercier Clémence Dallaire Richard Fleet Annie Leblanc Don Melady Denis Roy Samir Sinha Marie-Josée Sirois Holly O. Witteman Marcel Émond Josée Rivard Isabelle Pelletier Stéphane Turcotte Rawane Samb Raphaëlle Giguère Lyna Abrougui Pascal Y. Smith Patrick M. Archambault on behalf of the Network of Canadian Emergency Researchers |
| author_sort | Vanessa Couture |
| collection | DOAJ |
| description | Abstract Objective Improving care transitions for older adults can reduce emergency department (ED) visits, adverse events, and empower community autonomy. We conducted an inductive qualitative content analysis to identify themes emerging from comments to better understand ED care transitions. Methods The LEARNING WISDOM prospective longitudinal observational cohort includes older adults (≥ 65 years) who experienced a care transition after an ED visit from both before and during COVID-19. Their comments on this transition were collected via phone interview and transcribed. We conducted an inductive qualitative content analysis with randomly selected comments until saturation. Themes that arose from comments were coded and organized into frequencies and proportions. We followed the Standards for Reporting Qualitative Research (SRQR). Results Comments from 690 patients (339 pre-COVID, 351 during COVID) composed of 351 women (50.9%) and 339 men (49.1%) were analyzed. Patients were satisfied with acute emergency care, and the proportion of patients with positive acute care experiences increased with the COVID-19 pandemic. Negative patient comments were most often related to communication between health providers across the care continuum and the professionalism of personnel in the ED. Comments concerning home care became more neutral with the COVID-19 pandemic. Conclusion Patients were satisfied overall with acute care but reported gaps in professionalism and follow-up communication between providers. Comments may have changed in tone from positive to neutral regarding home care over the COVID-19 pandemic due to service slowdowns. Addressing these concerns may improve the quality of care transitions and provide future pandemic mitigation strategies. |
| first_indexed | 2024-03-08T16:13:09Z |
| format | Article |
| id | doaj.art-3e3c744f72794911a13279b6f468f3c6 |
| institution | Directory Open Access Journal |
| issn | 1471-2318 |
| language | English |
| last_indexed | 2024-03-08T16:13:09Z |
| publishDate | 2024-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Geriatrics |
| spelling | doaj.art-3e3c744f72794911a13279b6f468f3c62024-01-07T12:43:54ZengBMCBMC Geriatrics1471-23182024-01-0124111710.1186/s12877-023-04482-0Transitions of care for older adults discharged home from the emergency department: an inductive thematic content analysis of patient commentsVanessa Couture0Nathalie Germain1Émilie Côté2Lise Lavoie3Joanie Robitaille4Michèle Morin5Josée Chouinard6Yves Couturier7France Légaré8Marie-Soleil Hardy9Lucas B. Chartier10Audrey-Anne Brousseau11Nadia Sourial12Éric Mercier13Clémence Dallaire14Richard Fleet15Annie Leblanc16Don Melady17Denis Roy18Samir Sinha19Marie-Josée Sirois20Holly O. Witteman21Marcel Émond22Josée Rivard23Isabelle Pelletier24Stéphane Turcotte25Rawane Samb26Raphaëlle Giguère27Lyna Abrougui28Pascal Y. Smith29Patrick M. Archambault30on behalf of the Network of Canadian Emergency Researchers31Centre de recherche intégrée pour un système apprenant en santé et services sociaux, Centre intégré de santé et services sociaux de Chaudière-AppalachesCentre de recherche intégrée pour un système apprenant en santé et services sociaux, Centre intégré de santé et services sociaux de Chaudière-AppalachesCentre de recherche intégrée pour un système apprenant en santé et services sociaux, Centre intégré de santé et services sociaux de Chaudière-AppalachesCentre de recherche intégrée pour un système apprenant en santé et services sociaux, Centre intégré de santé et services sociaux de Chaudière-AppalachesCentre de recherche intégrée pour un système apprenant en santé et services sociaux, Centre intégré de santé et services sociaux de Chaudière-AppalachesCentre de recherche intégrée pour un système apprenant en santé et services sociaux, Centre intégré de santé et services sociaux de Chaudière-AppalachesCentre de recherche intégrée pour un système apprenant en santé et services sociaux, Centre intégré de santé et services sociaux de Chaudière-AppalachesDepartment of Social Work, Université de SherbrookeFaculty of Medicine, Université LavalCentre de recherche intégrée pour un système apprenant en santé et services sociaux, Centre intégré de santé et services sociaux de Chaudière-AppalachesDepartment of Emergency Medicine, University Health NetworkDepartment of Family Medicine, Université de SherbrookeDepartment of Health Management, Evaluation and Policy, School of Public Health, Université de MontréalFaculty of Medicine, Université LavalCentre de recherche intégrée pour un système apprenant en santé et services sociaux, Centre intégré de santé et services sociaux de Chaudière-AppalachesCentre de recherche intégrée pour un système apprenant en santé et services sociaux, Centre intégré de santé et services sociaux de Chaudière-AppalachesCentre de recherche intégrée pour un système apprenant en santé et services sociaux, Centre intégré de santé et services sociaux de Chaudière-AppalachesDepartment of Family and Community Medicine, University of TorontoCommissaire à la santé et au bien-être (CSBE)Department of Family and Community Medicine, University of TorontoFaculty of Medicine, Université LavalFaculty of Medicine, Université LavalFaculty of Medicine, Université LavalCentre de recherche intégrée pour un système apprenant en santé et services sociaux, Centre intégré de santé et services sociaux de Chaudière-AppalachesCentre de recherche intégrée pour un système apprenant en santé et services sociaux, Centre intégré de santé et services sociaux de Chaudière-AppalachesCentre de recherche intégrée pour un système apprenant en santé et services sociaux, Centre intégré de santé et services sociaux de Chaudière-AppalachesCentre de recherche intégrée pour un système apprenant en santé et services sociaux, Centre intégré de santé et services sociaux de Chaudière-AppalachesCentre de recherche intégrée pour un système apprenant en santé et services sociaux, Centre intégré de santé et services sociaux de Chaudière-AppalachesCentre de recherche intégrée pour un système apprenant en santé et services sociaux, Centre intégré de santé et services sociaux de Chaudière-AppalachesCentre de recherche intégrée pour un système apprenant en santé et services sociaux, Centre intégré de santé et services sociaux de Chaudière-AppalachesCentre de recherche intégrée pour un système apprenant en santé et services sociaux, Centre intégré de santé et services sociaux de Chaudière-AppalachesNetwork of Canadian Emergency ResearchersAbstract Objective Improving care transitions for older adults can reduce emergency department (ED) visits, adverse events, and empower community autonomy. We conducted an inductive qualitative content analysis to identify themes emerging from comments to better understand ED care transitions. Methods The LEARNING WISDOM prospective longitudinal observational cohort includes older adults (≥ 65 years) who experienced a care transition after an ED visit from both before and during COVID-19. Their comments on this transition were collected via phone interview and transcribed. We conducted an inductive qualitative content analysis with randomly selected comments until saturation. Themes that arose from comments were coded and organized into frequencies and proportions. We followed the Standards for Reporting Qualitative Research (SRQR). Results Comments from 690 patients (339 pre-COVID, 351 during COVID) composed of 351 women (50.9%) and 339 men (49.1%) were analyzed. Patients were satisfied with acute emergency care, and the proportion of patients with positive acute care experiences increased with the COVID-19 pandemic. Negative patient comments were most often related to communication between health providers across the care continuum and the professionalism of personnel in the ED. Comments concerning home care became more neutral with the COVID-19 pandemic. Conclusion Patients were satisfied overall with acute care but reported gaps in professionalism and follow-up communication between providers. Comments may have changed in tone from positive to neutral regarding home care over the COVID-19 pandemic due to service slowdowns. Addressing these concerns may improve the quality of care transitions and provide future pandemic mitigation strategies.https://doi.org/10.1186/s12877-023-04482-0Emergency departmentCare transitionsPatient experienceAgingCOVID-19Geriatrics |
| spellingShingle | Vanessa Couture Nathalie Germain Émilie Côté Lise Lavoie Joanie Robitaille Michèle Morin Josée Chouinard Yves Couturier France Légaré Marie-Soleil Hardy Lucas B. Chartier Audrey-Anne Brousseau Nadia Sourial Éric Mercier Clémence Dallaire Richard Fleet Annie Leblanc Don Melady Denis Roy Samir Sinha Marie-Josée Sirois Holly O. Witteman Marcel Émond Josée Rivard Isabelle Pelletier Stéphane Turcotte Rawane Samb Raphaëlle Giguère Lyna Abrougui Pascal Y. Smith Patrick M. Archambault on behalf of the Network of Canadian Emergency Researchers Transitions of care for older adults discharged home from the emergency department: an inductive thematic content analysis of patient comments BMC Geriatrics Emergency department Care transitions Patient experience Aging COVID-19 Geriatrics |
| title | Transitions of care for older adults discharged home from the emergency department: an inductive thematic content analysis of patient comments |
| title_full | Transitions of care for older adults discharged home from the emergency department: an inductive thematic content analysis of patient comments |
| title_fullStr | Transitions of care for older adults discharged home from the emergency department: an inductive thematic content analysis of patient comments |
| title_full_unstemmed | Transitions of care for older adults discharged home from the emergency department: an inductive thematic content analysis of patient comments |
| title_short | Transitions of care for older adults discharged home from the emergency department: an inductive thematic content analysis of patient comments |
| title_sort | transitions of care for older adults discharged home from the emergency department an inductive thematic content analysis of patient comments |
| topic | Emergency department Care transitions Patient experience Aging COVID-19 Geriatrics |
| url | https://doi.org/10.1186/s12877-023-04482-0 |
| work_keys_str_mv | AT vanessacouture transitionsofcareforolderadultsdischargedhomefromtheemergencydepartmentaninductivethematiccontentanalysisofpatientcomments AT nathaliegermain transitionsofcareforolderadultsdischargedhomefromtheemergencydepartmentaninductivethematiccontentanalysisofpatientcomments AT emiliecote transitionsofcareforolderadultsdischargedhomefromtheemergencydepartmentaninductivethematiccontentanalysisofpatientcomments AT liselavoie transitionsofcareforolderadultsdischargedhomefromtheemergencydepartmentaninductivethematiccontentanalysisofpatientcomments AT joanierobitaille transitionsofcareforolderadultsdischargedhomefromtheemergencydepartmentaninductivethematiccontentanalysisofpatientcomments AT michelemorin transitionsofcareforolderadultsdischargedhomefromtheemergencydepartmentaninductivethematiccontentanalysisofpatientcomments AT joseechouinard transitionsofcareforolderadultsdischargedhomefromtheemergencydepartmentaninductivethematiccontentanalysisofpatientcomments AT yvescouturier transitionsofcareforolderadultsdischargedhomefromtheemergencydepartmentaninductivethematiccontentanalysisofpatientcomments AT francelegare transitionsofcareforolderadultsdischargedhomefromtheemergencydepartmentaninductivethematiccontentanalysisofpatientcomments AT mariesoleilhardy transitionsofcareforolderadultsdischargedhomefromtheemergencydepartmentaninductivethematiccontentanalysisofpatientcomments AT lucasbchartier transitionsofcareforolderadultsdischargedhomefromtheemergencydepartmentaninductivethematiccontentanalysisofpatientcomments AT audreyannebrousseau transitionsofcareforolderadultsdischargedhomefromtheemergencydepartmentaninductivethematiccontentanalysisofpatientcomments AT nadiasourial transitionsofcareforolderadultsdischargedhomefromtheemergencydepartmentaninductivethematiccontentanalysisofpatientcomments AT ericmercier transitionsofcareforolderadultsdischargedhomefromtheemergencydepartmentaninductivethematiccontentanalysisofpatientcomments AT clemencedallaire transitionsofcareforolderadultsdischargedhomefromtheemergencydepartmentaninductivethematiccontentanalysisofpatientcomments AT richardfleet transitionsofcareforolderadultsdischargedhomefromtheemergencydepartmentaninductivethematiccontentanalysisofpatientcomments AT annieleblanc transitionsofcareforolderadultsdischargedhomefromtheemergencydepartmentaninductivethematiccontentanalysisofpatientcomments AT donmelady transitionsofcareforolderadultsdischargedhomefromtheemergencydepartmentaninductivethematiccontentanalysisofpatientcomments AT denisroy transitionsofcareforolderadultsdischargedhomefromtheemergencydepartmentaninductivethematiccontentanalysisofpatientcomments AT samirsinha transitionsofcareforolderadultsdischargedhomefromtheemergencydepartmentaninductivethematiccontentanalysisofpatientcomments AT mariejoseesirois transitionsofcareforolderadultsdischargedhomefromtheemergencydepartmentaninductivethematiccontentanalysisofpatientcomments AT hollyowitteman transitionsofcareforolderadultsdischargedhomefromtheemergencydepartmentaninductivethematiccontentanalysisofpatientcomments AT marcelemond transitionsofcareforolderadultsdischargedhomefromtheemergencydepartmentaninductivethematiccontentanalysisofpatientcomments AT joseerivard transitionsofcareforolderadultsdischargedhomefromtheemergencydepartmentaninductivethematiccontentanalysisofpatientcomments AT isabellepelletier transitionsofcareforolderadultsdischargedhomefromtheemergencydepartmentaninductivethematiccontentanalysisofpatientcomments AT stephaneturcotte transitionsofcareforolderadultsdischargedhomefromtheemergencydepartmentaninductivethematiccontentanalysisofpatientcomments AT rawanesamb transitionsofcareforolderadultsdischargedhomefromtheemergencydepartmentaninductivethematiccontentanalysisofpatientcomments AT raphaellegiguere transitionsofcareforolderadultsdischargedhomefromtheemergencydepartmentaninductivethematiccontentanalysisofpatientcomments AT lynaabrougui transitionsofcareforolderadultsdischargedhomefromtheemergencydepartmentaninductivethematiccontentanalysisofpatientcomments AT pascalysmith transitionsofcareforolderadultsdischargedhomefromtheemergencydepartmentaninductivethematiccontentanalysisofpatientcomments AT patrickmarchambault transitionsofcareforolderadultsdischargedhomefromtheemergencydepartmentaninductivethematiccontentanalysisofpatientcomments AT onbehalfofthenetworkofcanadianemergencyresearchers transitionsofcareforolderadultsdischargedhomefromtheemergencydepartmentaninductivethematiccontentanalysisofpatientcomments |