Interventions to Improve Transitional Care Between Nursing Homes and Hospitals: A Systematic Review
Open accessAbstract
Transitions between healthcare settings are associated with errors in communication of information and treatment plans for frail older patients, but strategies to improve transitional care are lacking. A systematic review was conducted to identify and evaluate interventions to improve communication of accurate and appropriate medication lists and advance directives for elderly patients who transition between nursing homes and hospitals. MEDLINE, ISI Web, and EBSCO Host (from inception to June 2008) were searched for original, English‐language research articles reporting interventions to improve communication of medication lists and advance directives. Five studies ultimately met all inclusion criteria. Two described interventions that enhanced transmission of advance directives, two described interventions that improved communication of medication lists, and one intervention addressed both goals. One study was a randomized controlled trial, whereas the remaining studies used historical or no controls. Study results indicate that a standardized patient transfer form may assist with the communication of advance directives and medication lists and that pharmacist‐led review of medication lists may help identify omitted or indicated medications on transfer. Although preliminary evidence supports adoption of these methods to improve transitions between nursing home and hospital, further research is needed to define target populations and outcomes measures for high‐quality transitional care.
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Transitions in care for older people lead to error, breaches of patient safety, rehospitalisation and mortality.
“It is widely reported that transitions in care for older people lead to error, breaches of patient safety, rehospitalisation and mortality [11–13].”
From Stakeholder perspectives of care for people living with dementia moving from hospital to care facilities in the community: a systematic review (2019) · cites this paper as [12]
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- Authors
- LaMantia, M. A., Scheunemann, L. P., Viera, A. J., Busby‐Whitehead, J., & Hanson, L. C.
- Affiliations
- University of North Carolina at Chapel Hill (US)
- Venue
- Journal of the American Geriatrics Society
- Publisher
- Wiley
- Published
- 2010-04
- Volume
- 58
- Issue
- 4
- Pages
- 777-782
- ISSN
- 0002-8614 (ISSN-L)
- 1532-5415
- PMC
- PMC4407558
- OpenAlex
- W1584798222
- Cited by
- 189
- References
- 33
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 16 · 2023: 10 · 2022: 7 · 2021: 8 · 2020: 14 · 2019: 15 · 2018: 12 · 2017: 13 · 2016: 11 · 2015: 17 · 2014: 18 · 2013: 16 · 2012: 11
- FWCI
- 2.30
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of the American Geriatrics Society (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- BIBSYS Brage (BIBSYS (Norway)) (submittedVersion)
- NORA - Norwegian Open Research Archives (submittedVersion, other-oa)
- Funders
- National Institute on Aging (T32AG000272)
- Topics
- Health Sciences › Medicine › Emergency Medicine › Hospital Admissions and Outcomes
- Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
- Health Sciences › Health Professions › General Health Professions › Geriatric Care and Nursing Homes
- Keywords
- care transitions, nursing homes, hospital discharge, advance directives, medication lists, frail elderly patients, pharmacist medication review
- MeSH terms
- Aged, Communication Barriers, Continuity of Patient Care, Drug Therapy, Hospitals, Humans, Nursing Homes, Patient Discharge, Patient Transfer, Research Design, Advance Directives, Frail Elderly, Total Quality Management, Patient-Centered Care, Medical Errors, Evidence-Based Practice, Checklist
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