103PERSPECTIVES ON QUALITY OF TRANSITIONAL CARE FROM HOSPITAL TO HOME FOR VULNERABLE OLDER PATIENTS

Abstract

Background: Good quality transitional care may partly prevent negative health outcomes and readmissions for vulnerable older patients after hospital discharge. For good quality care, patient satisfaction is important. However, little is known about factors of influence on vulnerable older patients' satisfaction with transitional care. Therefore, the objective of this study is to explore possible factors of influence on vulnerable older patients' satisfaction with the transfer of care from hospital to primary care. Methods: Semi-structured interviews with vulnerable older patients who received homecare after hospital discharge (n = 13) and their informal caregivers (n = 10) and focus groups with hospital- and homecare nurses (n = 9) were performed, audio recorded and transcribed verbatim. By making use of the framework method, factors of influence on vulnerable older patients' satisfaction with the transfer of care were identified. Results: Overall, patients (mean age 85.5 years (SD 1.5) were satisfied with the received transitional care (mean rating 8.1 points (SD 0.3). From the perspective of vulnerable older patients and their informal caregivers, as well as from the perspective of nurses, factors of influence on satisfaction with the transfer of care were assurance of continuity of care before discharge takes place, good continuity of care at the moment of discharge, information provision to both the older patients and the informal caregiver and attention for personal wishes and needs of the patient and the informal caregiver. Furthermore, the factors medication transmission, trust in the professional care providers involved and empathy of the care providers involved were mentioned only by patients and their informal caregivers. Discussion: Transitional care for vulnerable older patients can be optimised by focussing on the organisational factors of assurance of continuity of care before discharge takes place, good continuity of care at the moment of discharge, information provision, attention for personal wishes and needs and medication transmission. Furthermore, we recommend to draw professional healthcare providers' attention to the importance of trust and empathy in vulnerable older patients' satisfaction and to systematically involve informal caregivers in transitional care.