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. 2021 Oct:96:103509.
doi: 10.1016/j.apergo.2021.103509. Epub 2021 Jun 19.

Disparate perspectives: Exploring healthcare professionals' misaligned mental models of older adults' transitions of care between the emergency department and skilled nursing facility

Nicole E Werner  1 , Rachel A Rutkowski  2 , Sheryl Krause  2 , Hanna J Barton  2 , Kathryn Wust  2 , Peter Hoonakker  2 , Barbara King  2 , Manish N Shah  2 , Michael S Pulia  2 , Maria Brenny-Fitzpatrick  2 , Maureen Smith  2 , Pascale Carayon  2
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Disparate perspectives: Exploring healthcare professionals' misaligned mental models of older adults' transitions of care between the emergency department and skilled nursing facility

Nicole E Werner et al. Appl Ergon. 2021 Oct.

Abstract

Care transitions that occur across healthcare system boundaries represent a unique challenge for maintaining high quality care and patient safety, as these systems are typically not aligned to perform the care transition process. We explored healthcare professionals' mental models of older adults' transitions between the emergency department (ED) and skilled nursing facility (SNF). We conducted a thematic analysis of interviews with ED and SNF healthcare professionals and identified three themes: 1) ED and SNF healthcare professionals had misaligned mental models regarding communication processes and tools used during care transitions, 2) ED and SNF healthcare professionals had misaligned mental models regarding healthcare system capability, and 3) Misalignments led to individual and organizational consequences. Overall, we found that SNF and ED healthcare professionals are part of the same process but have different perceptions of the process. Future work must take steps to redesign and realign these distinct work systems such that those involved conceptualize themselves as part of a joint process.

Keywords: Care transitions; Emergency department; Macroergonomics; Mental models; Older adults; Skilled nursing facility.

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Conflict of interest statement

Declaration of interests

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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