Assessment tools addressing avoidable care transitions in older adults: a systematic literature review

Abstract

Purpose: The phenomenon of avoidable care transitions has received increasing attention over the last decades due to its frequency and associated burden for the patients and the healthcare system. A number of assessment tools to identify avoidable transitions have been designed and implemented. The selection of the most appropriate tool appears to be challenging and time-consuming. This systematic review aimed to identify and comprehensively describe the assessment tools that can support stakeholders´ care transition decisions on older adults.

Methods: This study was conducted as part of the TRANS-SENIOR research network. A systematic search was conducted in MEDLINE via PubMed, CINAHL, and CENTRAL. No restrictions regarding publication date and language were applied.

Results: The search in three electronic databases revealed 1266 references and screening for eligibility resulted in 58 articles for inclusion. A total of 48 assessment tools were identified covering different concepts, judgement processes, and transition destinations. We found variation in the comprehensiveness of the tools with regard to dimensions used in the judgement process.

Conclusion: All tools are not comprehensive with respect to the dimensions covered, as they address only one or a few perspectives. Although assessment tools can be useful in clinical practice, it is worth it to bear in mind that they are meant to support decision-making and supplement the care professional´s judgement, instead of replacing it. Our review might guide clinicians and researchers in choosing the right tool for identification of avoidable care transitions, and thus support informed decision-making.

Keywords: Decision support tools; Decision-making; Older adults; Preventable care transitions.

Fig. 1

PRISMA flow diagram for studies screened as part of category 1

Fig. 2

PRISMA flow diagram for studies screened as part of category 2