"Just tell me in a simple way": A qualitative study on opportunities to improve the transition from acute hospital care to home from the perspectives of patients with traumatic brain injury, families, and providers.

ABSTRACT

OBJECTIVE: The purpose of this study was to identify areas to improve the transition from acute hospital care to home for patients with traumatic brain injury and their families. DESIGN: Qualitative, descriptive. SETTING: Level I trauma centered located in the Southeastern United States. SUBJECTS: A total of 36 participants (12 patients with traumatic brain injury, 8 family caregivers, 16 providers). MAIN MEASURES: We conducted 55 semi-structured interviews with participants and used conventional content analysis to analyze the data. RESULTS: Findings showed patients, families, and providers recommend three areas for improvement in the transition home from acute hospital care, described in three themes. Theme 1 was "improving patient and family education," with the following sub-themes (a) TBI-related information and (b) discharge preparation. Theme 2 was "additional provider guidance," with the following sub-themes (a) communication about patient's recovery timeline and (b) recovery roadmap development. Theme 3 was "increasing systems-level support," with the following sub-themes (a) scheduling follow-up appointments, (b) using a patient navigator, (c) creating a provider follow-up structure, (d) linking pre-discharge care with post-discharge resources, and (e) addressing social issues. CONCLUSIONS: These findings delineate multiple areas where patients and families need additional support and education during the transition from acute hospital care to home in ways that are currently not being addressed. Findings may be used to improve education and support from providers and health systems given to patients with traumatic brain injury and families and to inform development and testing of transitional care interventions from acute hospital care to home.