Transition Care versus Handover Communication PICOT:
For the elderly population (P), does the use of transition care programs or interventions (I) compared to handover communication techniques (C) reduce the rate of hospital readmissions (O) when transferring patients from one setting to another within 30 days (O)? And how it can result in a positive patient outcome.
Benefits of Transition Care Program to Patient Outcome
Transition care and handover are critical factors in ensuring patient safety and quality of life when changing theenvironment. Researchers define transition care as the set of activities that guarantee continuity when moving patients from one location to another or transferring within different care levels. Patient handover communication is the transfer of information between the providers when exchanging patients. The two forms of transition have different levels of input on safety and quality and outcome care. Previous research has explored the input of each technique;some of the benefits associated with transition care programs include access to the multidisciplinary care team, intimate environment, minimization of inappropriate hospital stay, closeness to family and faster way to home (Manshukai et al, 2015).
Comparison of Patient Populations
Abraham et al, (2012)explored the effectiveness of a handoff method and concluded that standard Handoff checklist contributes positively to the provision of care. A comparison of elderly patients under transition care and handover communication revealed that transition care works best since the elderly require alonger time to adjust to a change. Sluisveld et al, (2015)studiedhow to improve the quality of life during handover of thepatientand concluded that a combination of both is the ultimate tool, besides the documentation advantages, the model by itself may fail to meet some needs of the elderly necessitating a transition care. In a research by Brown (2014), transition care works better if communication is effectivewhen the population in questions are elderly. Manshukai et al (2015) noted that while handover communication may be effective, errors in communication may affect thequality of care, the study suggested that transition care is effective for the elderly, by comparing patient care, the authors noted that transition care has lesser chances of leading to hospital readmission. The studies show a preference for the use of transition careas the method effective modelbut note the importance of handover communication in the process.
The transition of care is easy to implement in nursing setup. The implementation requires staffing of the multidisciplinary team consisting nurses, physicians, social workers and others deemed essential, this will take three months. The handling of patients will follow standard implementation timelines, which entail:
- Daily APN visit in hospital
- 24-72 hour home visits after discharge
- Weekly visits duringhomecare for up to 12 months
- 24/7 access to APN via phone and acute visits
- 24-hour access to the multidisciplinary care team.
The four sources identified noted that both tools are effective in ensuring patient safety; however, transition care offered more when caring for the elderly. While handover communication promotes patient safety, it may not adequately take care of the patient’s new environment. Transition care increases the patient’s adaptation to changes. Three of the sources favor the use of transition care over handover communication suggesting that it is more effective.
Abraham J, Thomas K, Bela P, Khalid A, & Vimla L (2012). Ensuring Patient Safety in Care Transitions: An Empirical Evaluation of a Handoff Intervention Tool. AMIA Annu Symp Proc. 17–26. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3540511/
Brown, G. (2014). Improving Handover of Care. The Canadian Journal Of Hospital Pharmacy, 67(4). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4152962/
Mansukhani R, Mary B, Danielle C, & Laurie J. (2015). Exploring Transitional Care: Evidence-Based Strategies for Improving Provider Communication and Reducing Readmissions. The Canadian Journal Of Hospital Pharmacy, 40(10), 690–694. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4606859/
Sluisveld, N., Hesselink, G., van der Hoeven, J., Westert, G., Wollersheim, H., & Zegers, M. (2015). Improving clinical handover between intensive care unit and general ward professionals at intensive care unit discharge. Intensive Care Medicine, 41(4), 589-604. https://www.ncbi.nlm.nih.gov/pubmed/?term=Sluisveld%2C+N.%2C+Hesselink%2C+G.%2C+van+der+Hoeven%2C+J.%2C+Westert%2C+G.%2C+Wollersheim%2C+H.%2C+%26+Zegers%2C+M.+(2015).+Improving+clinical+handover+between+intensive+care+unit+and+general+ward