Transition of Care
Conditions
Keywords
care transitions, low English proficiency, Spanish-speaking patients, qualitative research, healthcare equity, communication barriers, cultural competence, translators
Brief summary
The overall goal of this proposed study is to characterize the experiences, barriers and facilitators related to providing effective care transitions from hospital to post-acute care settings to elucidate the failures that drive disparate outcomes using qualitative methodology and to ultimately adapt standardized processes to close the equity gap.
Detailed description
Current care transition requires adaptation to address persistently worse outcomes for minoritized patients. For those who speak English, there are multiple spontaneous interactions with the healthcare team in addition to formal discharge teaching. Those with LEP have limited, scheduled time (where family may not be available) to ask questions and receive the bulk of discharging instructions in one setting. Even if meeting standards, there is variation in interpreter-services practice (e.g., video-based). We strive for standardization of implementation in most hospital processes rather than adaptation to meet the needs of individuals in order to achieve equitable clinical results. Hospital care quality improvement processes rarely include contextual narratives of the impact in historically marginalized individuals. Furthermore, clinical trials often fail to describe "success" from a patient or their caregivers' perspective. This study brings an innovative team with expertise in mixed methodology to focus on patient experience and equity to improve the value of transition processes from hospitals to SNFs.
Interventions
None listed
Sponsors
University of Washington
Donaghue Medical Research Foundation
Study design
Observational model
OTHER
Time perspective
OTHER
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Inpatient hospitalization at the University of Washington (UW) Medical Center Designated as Spanish- speaking in the EPIC electronic medical record (EMR) Designated as needing an interpreter in the EMR Being discharged to any skilled nursing facility
Exclusion criteria
Patients who were unable to participate in a qualitative interview due to neurocognitive conditions such as dementia or schizophrenia were excluded from the study. \-
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Qualitative Themes Identified From Semi-Structured Interviews With Spanish-Speaking Patients and Caregivers | Interviews conducted within 7 days of transfer to a skilled nursing facility (SNF) | The primary outcome is the set of qualitative themes identified through inductive content analysis of semi-structured interview transcripts. Interview transcripts will be coded using a structured codebook, and emergent themes related to communication, language needs, barriers, facilitators, and care transition experiences will be identified and categorized. |
Countries
United States
Contacts
PRINCIPAL_INVESTIGATORGiana Davidson, MD, MPH
University of Washington
Outcome results
None listed