WFRF:(Ekstedt Mirjam Professor)
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- Hedqvist, Ann-Therese,DoktorandLinnéuniversitetet,Institutionen för hälso- och vårdvetenskap (HV),Region Kalmar County, Sweden,Department of Health and Caring Sciences, Linnaeus University, Kalmar, Sweden (author)
Exploring interdependencies, vulnerabilities, gaps and bridges in care transitions of patients with complex care needs using the Functional Resonance Analysis Method
- Article/chapterEnglish2023
Publisher, publication year, extent ...
- BioMed Central (BMC),2023
- printrdacarrier
Numbers
- LIBRIS-ID:oai:DiVA.org:lnu-123671
- https://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-123671URI
- https://doi.org/10.1186/s12913-023-09832-7DOI
- https://urn.kb.se/resolve?urn=urn:nbn:se:vti:diva-19858URI
- http://kipublications.ki.se/Default.aspx?queryparsed=id:153472909URI
Supplementary language notes
- Language:English
- Summary in:English
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Notes
- BackgroundHospital discharge is a complex process encompassing multiple interactions and requiring coordination. To identify potential improvement measures in care transitions for people with complex care needs, intra- and inter-organisational everyday work needs to be properly understood, including its interdependencies, vulnerabilities and gaps. The aims of this study were to 1) map coordination and team collaboration across healthcare and social care organisations, 2) describe interdependencies and system variability in the discharge process for older people with complex care needs, and 3) evaluate the alignment between discharge planning and the needs in the home.MethodsData were collected through participant observations, interviews, and document review in a region of southern Sweden. The Functional Resonance Analysis Method (FRAM) was used to model the discharge process and visualise and analyse coordination of care across healthcare and social care organisations.ResultsHospital discharge is a time-sensitive process with numerous couplings and interdependencies where healthcare professionals’ performance is constrained by system design and organisational boundaries. The greatest vulnerability can be found when the patient arrives at home, as maladaptation earlier in the care chain can lead to an accumulation of issues for the municipal personnel in health and social care working closest to the patient. The possibilities for the personnel to adapt are limited, especially at certain times of day, pushing them to make trade-offs to ensure patient safety. Flexibility and appropriate resources enable for handling variability and responding to uncertainties in care after discharge.ConclusionsMapping hospital discharge using the FRAM reveals couplings and interdependencies between various individuals, teams, and organisations and the most vulnerable point, when the patient arrives at home. Resilient performance in responding to unexpected events and variations during the first days after the return home requires a system allowing flexibility and facilitating successful adaptation of discharge planning.
Subject headings and genre
- MEDICIN OCH HÄLSOVETENSKAP Hälsovetenskap Omvårdnad hsv//swe
- MEDICAL AND HEALTH SCIENCES Health Sciences Nursing hsv//eng
- Complexity
- care transitions
- hospital discharge
- patient safety
- resilience
- Functional Resonance Analysis Method
- Vårdvetenskap
- Caring Science
Added entries (persons, corporate bodies, meetings, titles ...)
- Praetorius, Gesa,1980-Statens väg- och transportforskningsinstitut,Förare och fordon, FOF,Department of Maritime Operations, University of South-Eastern Norway, Borre, Norway,Swedish National Road and Transport Research Institute, Sweden;University of South-Eastern Norway, Norway(Swepub:vti)gesa.praetorius@vti.se (author)
- Ekstedt, Mirjam,ProfessorLinnéuniversitetet,Institutionen för hälso- och vårdvetenskap (HV),Department of Health and Caring Sciences, Linnaeus University, Kalmar, Sweden; Department of Learning, Informatics, Management and Ethics, LIME, Karolinska Institutet, Stockholm, Sweden(Swepub:lnu)miekaa (author)
- LinnéuniversitetetInstitutionen för hälso- och vårdvetenskap (HV) (creator_code:org_t)
Related titles
- In:BMC Health Services Research: BioMed Central (BMC)23:11472-6963
Internet link
- https://doi.org/10.1186/s12913-023-09832-7Fulltext
- https://vti.diva-portal.org/smash/get/diva2:1792152/FULLTEXT01.pdffulltext:print
- https://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-123671
- https://doi.org/10.1186/s12913-023-09832-7
- https://urn.kb.se/resolve?urn=urn:nbn:se:vti:diva-19858
- http://kipublications.ki.se/Default.aspx?queryparsed=id:153472909
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