Essential information for transition of care for frail elderly patients in Japan: A qualitative study.

BACKGROUND: Information exchange between hospitals and primary care physicians is suboptimal. Most physicians are dissatisfied with the current referral process, and poor communication leads to negative care transition outcomes. METHOD: To identify the key information needed for a successful transition of care, we conducted a qualitative study using consecutive, semistructured in-person interviews and focus group sessions. We recruited five participants engaged in clinical work for individual interviews and 16 participants for focus groups. We analyzed all data using qualitative thematic analysis. All results were returned to the participants and modified based on their feedback. RESULTS: The five individual interviews provided a general picture of the current referral process and an interview guide for the following focus group sessions. The focus group discussions were used to identify the essential information needed at admission and discharge from the hospital. Essential information on hospital admission was as follows: (1) basic medical and care information, (2) care resources available at home, (3) the purpose of admission and the goals of care during hospitalization, and (4) status of advance care planning (ACP) and patient's will in an emergency. Essential information on hospital discharge was as follows: (1) clinical course, (2) explanation of medical condition during hospitalization, (3) status of ACP and patient's will in an emergency, and (4) medical procedures to be continued at home. CONCLUSIONS: We identified the essential information needed for a successful transition of care in Japan. The clinical effectiveness of a template that contains the information identified in our study warrants further investigation.

[Nationwide research on communication education curriculum in the faculty of pharmaceutical science. Second report: study of communication education curriculum before on-the-job training].

With the recent rapid shift in pharmaceutical education to the development of clinical experts, emphasis on education in humanism and communication has increased. However, there is a lack of experience in these fields of pharmaceutical education in Japan, and there have been few studies on the curriculum, from admission to the pharmaceutical science to the stage before on-the-job training. Also our previous survey of communication-related education revealed there is no consensus on the interpretation of communication-related education. In this study, therefore, we investigated communication-related education is incorporated before on-the-job training at 46 schools of pharmaceutical science in Japan. Communication-related education was carried out at 26 (56.5%) of the 46 schools, and role-playing was incorporated in the program at 23 (88.5%) of these 26 schools. However, SP (simulated patient/standardized patient) was adopted at 12 (46.2%) of these 26 schools. There was a psychologist or a communication specialist on the staff at only 10 (38.5%) of these 26 schools, revealing the lack of instructors in these fields. Interest in education related to communication was generally weak at national and public universities, and marked differences in the approach to pharmaceutical education among university types were observed. The preparation of basic guidelines and textbooks for stepwise communication education from lower to higher grades and the training of instructors are urgently needed.