Health Care Worker Perceptions of Gaps and Opportunities to Improve Hospital-to-Hospice Transitions

Shigeko Izumi, Brie N. Noble, Carey B. Candrian, Jennifer Tjia, Jessica Bordley, Jennifer Mensik, Jon P. Furuno

Research output: Contribution to journalArticle

Abstract

Background: Care transitions from the hospital to hospice are a difficult time, and gaps during this transitions could cause poor care experiences and outcomes. However, little is known about what gaps exist in the hospital-to-hospice transition. Objectives: To understand the process of hospital-to-hospice transition and identify common gaps in the transition that result in unsafe or poor patient and family caregiver experiences. Design: We conducted a qualitative descriptive study using semistructured interviews with health care workers who are directly involved in hospital-to-hospice transitions. Participants were asked to describe the common practice of discharging patients to hospice or admitting patients from a hospital, and share their observations about hospital-to-hospice transition gaps. Setting/Subjects: Fifteen health care workers from three hospitals and three hospice programs in Portland, Oregon. Measurements: All interviews were audio recorded and analyzed using qualitative descriptive methods to describe current practices and identify gaps in hospital-to-hospice transitions. Results: Three areas of gaps in hospital-to-hospice transitions were identified: (1) low literacy about hospice care; (2) changes in medications; and (3) hand-off information related to daily care. Specific concerns included hospital providers giving inaccurate descriptions of hospice; discharge orders not including comfort medications for the transition and inadequate prescriptions to manage medications at home; and lack of information about daily care hindering smooth transition and continuity of care. Conclusion: Our findings identify gaps and suggest opportunities to improve hospital-to-hospice transitions that will serve as the basis for future interventions to design safe and high-quality hospital-to-hospice care transitions.

Original languageEnglish (US)
Pages (from-to)900-906
Number of pages7
JournalJournal of palliative medicine
Volume23
Issue number7
DOIs
StatePublished - Jul 1 2020

Keywords

  • care transitions
  • discharge planning
  • hospice

ASJC Scopus subject areas

  • Nursing(all)
  • Anesthesiology and Pain Medicine

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