Barriers to healthy transitions between nursing homes and emergency departments.

ABSTRACT

This study identifies barriers to healthy transitions between nursing homes and emergency departments by exploring current practices in both primary care (out-of-hours primary care and nursing homes) and specialist healthcare (ambulance services and emergency departments) organizations from the perspectives of healthcare professionals. The objective is to highlight areas where improvements to these transitions are most needed. NH residents frequently use acute healthcare services. Many have complex healthcare needs, requiring coordination across multiple providers and different healthcare settings. Transitions theory by Afaf Meleis inspired this study and helped identify barriers to healthy transitions between nursing homes and emergency departments. Eighteen qualitative interviews were conducted with healthcare professionals from nursing homes, ambulance services, out-of-hours primary care, and emergency departments. Three themes were identified from the interviews 1 staff burden, 2 discontinuity of care, and 3 transitions taking a toll on the well-being of residents. This study identifies critical areas needed to improve transitions between nursing homes and emergency departments. Many of the barriers to healthy transitions are systemic, suggesting that micro, meso, and macro-level efforts are needed.