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. 2021 Dec:268:1-8.
doi: 10.1016/j.jss.2021.06.032. Epub 2021 Jul 23.

Barriers to Post-Discharge Monitoring and Patient-Clinician Communication: A Qualitative Study

Brian C Brajcich  1 , Meagan L Shallcross  2 , Julie K Johnson  2 , Rachel Hae-Soo Joung  2 , Cassandra B Iroz  2 , Jane L Holl  3 , Karl Y Bilimoria  1 , Ryan P Merkow  4
Affiliations

Barriers to Post-Discharge Monitoring and Patient-Clinician Communication: A Qualitative Study

Brian C Brajcich et al. J Surg Res. 2021 Dec.

Abstract

Introduction: As postoperative length of stay has decreased for many operations, the proportion of complications occurring post-discharge is increasing. Early identification and management of these complications requires overcoming barriers to effective post-discharge monitoring and communication. The aim of this study was to identify barriers to post-discharge monitoring and patient-clinician communication through a qualitative study of surgical patients and clinicians.

Materials and methods: Semi-structured interviews and focus groups were held with gastrointestinal surgery patients and clinicians. Participants were asked about barriers to post-discharge monitoring and communication. Each transcript was coded by 2 of 4 researchers, and recurring themes related to communication and care barriers were identified.

Results: A total of 15 patients and 17 clinicians participated in interviews and focus groups. Four themes which encompassed barriers to post-discharge monitoring and communication were identified from patient interviews, and 4 barriers were identified from clinician interviews and focus groups. Patient-identified barriers included education and expectation setting, technology access and literacy, availability of resources and support, and misalignment of communication preferences, while clinician-identified barriers included health education, access to clinical team, healthcare practitioner time constraints, and care team experience and consistency.

Conclusions: Multiple barriers exist to effective post-discharge monitoring and patient-clinician communication among surgical patients. These barriers must be addressed to develop an effective system for post-discharge care after surgery.

Keywords: Communication; Continuity of patient care; Gastrointestinal surgical procedures; Patient discharge; Qualitative research; Surgical oncology.

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References

    1. Centers for Medicare and Medicaid Services. Hospital-Acquired Condition (HAC) Reduction Program. https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Inst.... Published 2020. Accessed February 21, 2021.
    1. Centers for Medicare and Medicaid Services. Patient Safety Indicators (PSI). https://qualitynet.cms.gov/inpatient/measures/psi. Published 2021. Accessed February 21, 2021.
    1. Bilimoria KY, Cohen ME, Ingraham AM, et al. Effect of postdischarge morbidity and mortality on comparisons of hospital surgical quality. Ann Surg. 2010;252(1):183–190. - PubMed
    1. Kazaure HS, Roman SA, Sosa JA. Association of postdischarge complications with reoperation and mortality in general surgery. Arch Surg. 2012;147(11):1000–1007. - PubMed
    1. Yu P, Chang DC, Osen HB, Talamini MA. NSQIP reveals significant incidence of death following discharge. J Surg Res. 2011;170(2):e217–224. - PubMed

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