Hospital-to-Home Transitions for Lung Cancer Patients-A Qualitative Study of Healthcare Professionals' Experiences.

Abstract

Aims and objectives: To explore the professional practice of transferring patients with lung cancer from hospitals to their homes through the experiences of healthcare professionals (HCPs) working in hospitals.

Background: Hospital-to-home transitions are particularly challenging for vulnerable patients, including lung cancer patients, and could threaten patient safety. There is a need to improve coordination between specialised and community care and to develop knowledge on the practice of transferring patients with lung cancer.

Design: A descriptive qualitative design was used. Consolidated criteria for reporting qualitative research (COREQ) were followed for reporting.

Methods: Six focus group interviews with nurses and two focus group interviews with physicians at pulmonary medicine units in two hospitals in Norway were conducted. Qualitative content analysis was used to analyse the focus group interviews.

Results: Patients' vulnerability and gratitude motivated HCPs to ensure that patients experienced the best hospital-to-home transition. The following obstacles made it challenging to plan for a good hospital-to-home transition and to transfer the responsibility for the patient to the municipality: lack of time and routines to attend to the patient's individual needs, lack of established standards for patient information, absence of resources and predictability, and inadequate communication tools for collaborating with the primary healthcare services.

Conclusion: The healthcare system does not provide hospital units and HCPs with adequate resources to accommodate the individual needs of lung cancer patients in hospital-to-home transitions. HCPs compensate with supplementary initiatives to secure patient safety, but the additional responsibility and tasks leave them overworked.

Relevance to clinical practice: The study provides knowledge on lung cancer patients' needs in hospital-to-home transitions and how HCPs try to ensure patient safety by compensating for the healthcare system's deficiencies.

Public contribution: A reference group comprising one patient representative from the Norwegian Cancer Society and five HCPs with varied relevant backgrounds contributed to the overall design, recruited participants, and provided feedback on the interview guide.