Exploring success in sub-acute hospital-to-home transitions for palliative patients: a descriptive qualitative study.

Abstract

Background: Transitioning from a sub-acute hospital to home is highly desirable to some palliative and end-of-life individuals and their family caregivers, but the transition process itself is complex and can be logistically challenging. This formative assessment sought to better understand what constitutes a successful sub-acute hospital-to-home transition from the perspectives of health care providers connected to a sub-acute care facility in Ottawa, Canada, with reflections from a patient and a family caregiver.

Methods: Our descriptive qualitative study involved 13 virtual interviews and one virtual focus group between February and May 2023. Our sample included health care providers involved in the sub-acute hospital-to-home transition for palliative patients from a sub-acute facility, as well as one patient and one family caregiver who had experienced a palliative transition in this context. We used reflexive thematic analysis to code the data, and we inductively developed themes based on participants' experiences.

Results: We collected data from 14 health care providers, one patient, and one family caregiver who were involved in, or had experienced, a sub-acute hospital-to-home transition. We found three themes delineating participants' shared perceptions of the key foundations of a successful sub-acute hospital-to-home transition in the palliative context: meeting patient goals; sharing information to ensure informed decision-making; and having someone to coordinate the transition.

Conclusions: Our study highlighted that a successful sub-acute hospital-to-home transition should be person-centred and requires effective communication and coordination, both within and across, hospital and home environments. These insights will help inform intervention co-design to improve palliative care transitions in the next phase of this project.