A recent systematic review of transitional care interventions (n = 12) for older people with chronic illnesses has shown the need for more involvement from patients and from their informal caregivers. Thus, care transitions, particularly from hospital to home, continue to be poorly managed and pose a high risk for harm.
Despite, the many studies that have trialed multifaceted care transition interventions to improve the patient experience and to reduce readmissions to hospital, the results have been inconsistent. Existing care transition models such as the Care Transitions Interventions (CTI) and the Transitional Care Model (TCM) can provide insight into interventions that can best support patients during care transitions. The challenges associated with care transitions are complex, and, thus require a multifaceted approach. PFCC practices during transitions in care are defined as: “a set of actions designed to ensure the coordination and continuation of health care as patients transfer between different locations or between levels of care within the same clinical setting”, p. There is growing consensus that engaging patients and families can improve the quality of their care, particularly when transitioning from hospital to home. Research shows that patients who are more involved in the decision-making process related to their care are better able to manage complex chronic conditions, have reduced anxiety and stress and have shorter lengths of stay in hospital. It may encompass the complete spectrum of engagement, from understanding patients’ experiences and perspectives with the health system to fully involving patients and families in improving the health of their communities. This engagement process is defined as “patients, families, their representatives, and health professionals working in active partnership at various levels across the healthcare system-direct care, organizational design and governance, and policy making-to improve health and health care”, p. Patient and family engagement is fundamental to both a PFCC approach to health delivery as well as to improving overall patient safety in our healthcare system. Providers who believe in PFCC will typically develop relationships, communicate, collaborate, share information and engage with patients and their families with regards to health care. Person- and-family-centered care (PFCC) allows the planning, delivery, and evaluation of health care to be grounded in mutually beneficial partnerships among health care providers, patients, and families. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Ĭompeting interests: The authors have declared that no competing interests exist.
This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.ĭata Availability: All relevant data are within the paper and its Supporting Information files.įunding: We would like to thank the Canadian Patient Safety Institute, Accreditation Canada, the Canadian Home Care Association, Patients for Patient Safety Canada, and the Registered Nurses’ Association of Ontario for financially supporting this study. Received: ApAccepted: JanuPublished: January 22, 2019Ĭopyright: © 2019 Backman et al. PLoS ONE 14(1):Įditor: Rosemary Frey, University of Auckland, NEW ZEALAND (2019) Safe and effective person- and family-centered care practices during transitions from hospital to home-A web-based Delphi technique. Citation: Backman C, Johnston S, Oelke ND, Kovacs Burns K, Hughes L, Gifford W, et al.
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