Are we "missing the big picture" in transitions of care? Perspectives of healthcare providers managing patients with unplanned hospitalization.
Hawa O Abu, Milena D Anatchkova, Nathaniel A Erskine and 4 others
PMID 30389062WHAT IT FOUND
Providers said discharge instructions were often too long, untailored, and rushed; poor handoffs, language barriers, and home safety issues complicated follow-up.
They valued caregivers but rarely noted caregiver burden.
Key findings
01Providers reported discharge instructions were often overloaded and usually not tailored to individual patients.
02Rushed discharge conversations and language barriers were described as major provider-to-patient communication failures.
03Providers reported caregiver involvement helped post-discharge adherence, while home safety and fall risk were discharge concerns.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The findings are exploratory and do not test whether any discharge strategy improves patient outcomes. The study was done at a single academic health center, so the perspectives may not apply elsewhere. The paper reports 20 enrolled and 15 completed interviews; the gap is not explained. Participants were mostly female and non-Hispanic White. The study did not include physiotherapists, dietitians, or social workers, so their discharge-planning perspectives were absent. This report covers provider interviews only; patient and caregiver findings are published elsewhere. Social desirability bias is possible, though prompts for both positive and negative experiences were used.
Declared interests
The study used data from a Patient Centered Outcomes Research Institute funded project. Author DDM consults for Bristol Myers Squibb, Pfizer, Samsung, FlexCon, and Philips, and has an ownership stake in Mobile Sense Technologies. All other authors declared no conflicts of interest.
The easy way to misread this
Do not use these themes as evidence that tailored discharge instructions, caregiver involvement, or home safety checks reduce readmissions. This was a single-site qualitative study of 15 providers and did not measure patient outcomes or test an intervention.