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Open Access 01-12-2024 | Research

Transitions of care for older adults discharged home from the emergency department: an inductive thematic content analysis of patient comments

Authors: Vanessa Couture, Nathalie Germain, Émilie Côté, Lise Lavoie, Joanie Robitaille, Michèle Morin, Josée Chouinard, Yves Couturier, France Légaré, Marie-Soleil Hardy, Lucas B. Chartier, Audrey-Anne Brousseau, Nadia Sourial, Éric Mercier, Clémence Dallaire, Richard Fleet, Annie Leblanc, Don Melady, Denis Roy, Samir Sinha, Marie-Josée Sirois, Holly O. Witteman, Marcel Émond, Josée Rivard, Isabelle Pelletier, Stéphane Turcotte, Rawane Samb, Raphaëlle Giguère, Lyna Abrougui, Pascal Y. Smith, Patrick M. Archambault, on behalf of the Network of Canadian Emergency Researchers

Published in: BMC Geriatrics | Issue 1/2024

Abstract

Objective

Improving care transitions for older adults can reduce emergency department (ED) visits, adverse events, and empower community autonomy. We conducted an inductive qualitative content analysis to identify themes emerging from comments to better understand ED care transitions.

Methods

The LEARNING WISDOM prospective longitudinal observational cohort includes older adults (≥ 65 years) who experienced a care transition after an ED visit from both before and during COVID-19. Their comments on this transition were collected via phone interview and transcribed. We conducted an inductive qualitative content analysis with randomly selected comments until saturation. Themes that arose from comments were coded and organized into frequencies and proportions. We followed the Standards for Reporting Qualitative Research (SRQR).

Results

Comments from 690 patients (339 pre-COVID, 351 during COVID) composed of 351 women (50.9%) and 339 men (49.1%) were analyzed. Patients were satisfied with acute emergency care, and the proportion of patients with positive acute care experiences increased with the COVID-19 pandemic. Negative patient comments were most often related to communication between health providers across the care continuum and the professionalism of personnel in the ED. Comments concerning home care became more neutral with the COVID-19 pandemic.

Conclusion

Patients were satisfied overall with acute care but reported gaps in professionalism and follow-up communication between providers. Comments may have changed in tone from positive to neutral regarding home care over the COVID-19 pandemic due to service slowdowns. Addressing these concerns may improve the quality of care transitions and provide future pandemic mitigation strategies.

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Title: Transitions of care for older adults discharged home from the emergency department: an inductive thematic content analysis of patient comments
Authors: Vanessa Couture
Nathalie Germain
Émilie Côté
Lise Lavoie
Joanie Robitaille
Michèle Morin
Josée Chouinard
Yves Couturier
France Légaré
Marie-Soleil Hardy
Lucas B. Chartier
Audrey-Anne Brousseau
Nadia Sourial
Éric Mercier
Clémence Dallaire
Richard Fleet
Annie Leblanc
Don Melady
Denis Roy
Samir Sinha
Marie-Josée Sirois
Holly O. Witteman
Marcel Émond
Josée Rivard
Isabelle Pelletier
Stéphane Turcotte
Rawane Samb
Raphaëlle Giguère
Lyna Abrougui
Pascal Y. Smith
Patrick M. Archambault
on behalf of the Network of Canadian Emergency Researchers
Publication date: 01-12-2024
Publisher: BioMed Central
Published in: BMC Geriatrics / Issue 1/2024
Electronic ISSN: 1471-2318
DOI: https://doi.org/10.1186/s12877-023-04482-0

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