Abstract
Background/Aim Inadequate patient engagement and other factors put many older adults at high risk for adverse events during hospital-to-home transitions. Nearly half of all hospitalized consumers experience one or more medical errors following hospital discharge and almost 25% experience an adverse event related to these errors. However, through interventions that address these transitions from hospital to home and their potential risks, many of these errors can be prevented. Currently, most patient-directed care transition interventions are initiated during hospital stays. By actively involving older adults in a patient engagement intervention prior to hospitalization, skills can be learned that could reduce their risk of an adverse event occurring during the hospital-to-home transition.
Method This is a pilot study of the feasibility and efficacy of a new intervention for older adult patients. Standardized clinicians (SCs) will participate in scenarios designed to teach and assess older adults’ skills for actively participating in hospital-to-home transitions. Patients 65 and older will be recruited from the Scott & White Healthcare system. Participants will take part in a simulated transition from hospital to home with the SCs, followed by a debriefing session. Participants will then attend a workshop that will introduce intervention tools and role play activities to facilitate active engagement in hospital-to-home transitions. The workshop will be followed by additional simulation scenarios. Three months later, participants will return to complete a follow-up scenario session where simulation scenarios will be experienced again. The retention of transition-related behaviors learned in the first session will be evaluated. Impact of the intervention will be evaluated using self-report measures, observed transition-related behaviors during simulated scenarios, and qualitative reports of SCs. The intervention group will be compared to a non-intervention control group.
Expected Results Participants are expected to demonstrate more transition-related health behaviors (e.g., asking relevant questions at discharge, reconciling medications, and documenting goals) after training compared to pre-training. Behaviors are expected to persist after three months. SCs are expected to report benefits of the SC experience in addition to suggestions for improving the value of the intervention experience both for participants and for SCs.
