@article{eab68e6217ab4339aff978984ef91efc,
title = "An alternate level of care plan: Co-designing components of an intervention with patients, caregivers and providers to address delayed hospital discharge challenges",
abstract = "Objective: To engage with patients, caregivers and care providers to co-design components of an intervention that aims to improve delayed hospital discharge experiences. Design: This is a qualitative study, which entailed working groups and co-design sessions utilizing World Caf{\'e} and deliberative dialogue techniques to continually refine the intervention. Setting and Participants: Our team engaged with 61 participants (patients, caregivers and care providers) in urban and rural communities across Ontario, Canada. A 7-member Patient and Caregiver Advisory Council participated in all stages of the research. Results: Key challenges experienced during a delayed discharge by patients, caregivers and care providers were poor communication and a lack of care services. Participants recommended a communication guide to support on-going conversation between care providers, patients and caregivers. The guide included key topics to cover and questions to ask during initial and on-going conversations to manage expectations and better understand the priorities and goals of patients and caregivers. Service recommendations included getting out of bed and dressed each day, addressing the psycho-social needs of patients through tailored activities and having a storyboard at the bedside to facilitate on-going engagement. Discussion and Conclusions: Our findings outline ways to meaningfully engage patients and caregivers during a delayed hospital discharge. Combining this with a minimal basket of services can potentially facilitate a better care experience and outcomes for patients, their care providers and families.",
keywords = "Canada, co-design, delayed hospital discharge, patient engagement, qualitative, transitions in care",
author = "Kerry Kuluski and Ho, {Julia W.} and Lauren Cadel and Sara Shearkhani and Charissa Levy and Michelle Marcinow and Allie Peckham and Jane Sandercock and Willison, {Donald J.} and Guilcher, {Sara J.T.}",
note = "Funding Information: This study was funded by a Canadian Institutes of Health Research (CIHR) Strategy for Patient Oriented Research Collaboration Grant (Fund Number: 157054), an Ontario Strategy for Patient Oriented Research (SPOR) SUPPORT Unit EMPOWER Award and Sinai Health System. In-kind contributions were provided by the Toronto-Central Local Health Integration Network. The authors gratefully acknowledge the members of the ALC Patient and Caregiver Advisory Council: Lisa Bennett, Lucy Bilotta, Bernadette Farrell, Gordon MacGregor, Ida McLaughlin (Council Chair), Murray Powell and Monika Syed for their on-going contributions to the research reported in this paper. Many of the Council members also provided feedback on this current paper which strengthened the overall content. The team also acknowledges the following people for their support with various components of the project which resulted in this paper: Elaine Burr, Sheila Furness, Shehnaz Fakim, Beverly Nickoloff, Paula Blackstien-Hirsch, Melissa Frew, Craig Madho, Shawn Tracy, Sarah Carbone, Kristina Kokorelias, Amanda Everall, Alana Armas and Sandra Dickau. Most importantly, the team acknowledges the 61 patients, caregivers and providers who shared their experiences and time to co-design the components of the intervention reported in this paper. The lead author was a Scientist at the Lunenfeld-Tanenbaum Research Institute for the first half of the study reported in the paper and was appointed the Dr Mathias Gysler Research Chair in Patient and Family Centered Care at the Institute for Better Health at Trillium Health Partners where she completed the study.",
year = "2020",
month = oct,
doi = "10.1111/hex.13094",
language = "English (US)",
volume = "23",
pages = "1155--1165",
journal = "Health Expectations",
issn = "1369-6513",
publisher = "Wiley-Blackwell",
number = "5",
}