An Assessment of Handover Culture and Preferred Information in the Transitions of Care of Elderly Patients

Abstract

Introduction Transitions of care for elderly patients in long term care (LTC) to the emergency department (ED) is fraught with communication challenges. Information preferred during these transitions has not been agreed upon. We sought to understand our local handover culture and identify what information is preferred in the transitions of care of these patients. Methods We performed a cross-sectional electronic survey that was distributed to 1470 healthcare providers (HCPs) and 82 patient and family advocates (PFAs) in two Canadian cities. The HCP group consisted of physicians and nurses in ED and LTC settings as well as paramedics. The survey was open for a period of one month with formal reminders sent weekly. Results A total of 12.9% of HCPs and 26.8% of PFAs responded to the survey. Only 41.3% of HCP respondents were aware of existing handover protocols and 83.2% indicated a desire for a single page handover form. HCPs identified concerns over handover culture surrounding workplace inefficiencies and increased demands to their time. Several preferred items of information in the transitions of care for the institutionalized elderly patient were also identified across both HCP and PFA groups. Conclusions Our study identified a need for improved local handover culture in transitions of care for the institutionalized elderly patient. We also identified the preferred elements of information during bilateral communication between LTC and the ED. Our results will be used to design a patient-centred handover form for future use in this population.

Keywords: communication; geriatrics; transitions of care.

Figure 1. Preferred information to be communicated between long term care facility and emergency care providers

Figure 2. Preferred information to be communicated between emergency care providers and long term care facilities