Risk Management During the Transition From Hospital to Home: A Multiple Case Study Documenting the Experience of Patients Living With a Major Neurocognitive Disorder, Their Caregivers, and Healthcare Professionals
Open accessAbstract
Understanding the risks in the months following hospital discharge is crucial for healthcare professionals to ensure the need for assistance is met. However, this may be challenging in the case of patients living with a major neurocognitive disorder (PLMNCD). Thus, it is important to incorporate patients’ and caregivers’ experiences of the transition from hospital to home in the risk assessment. This multiple case study comprised 7 PLMNCD, their caregivers, and occupational therapists. Fifty-four interviews, conducted just before, as well as 3 weeks and 3 to 6 months after hospital discharge, were qualitatively analyzed. Results revealed that risk management during the hospital-to-home transition is a dynamic process aimed at establishing a satisfactory routine while avoiding adverse events. This risk management process, which identifies challenges over time and between stakeholders, involves (a) determining the seriousness and acceptability of risks, (b) reflecting on ways to manage risks, and (c) taking steps to manage risks. This knowledge will help to provide more appropriate care and services that strike a balance between safety and autonomy.
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Carers' knowledge (e.g., health literacy, the patient's care needs) was linked to their experience of carer burden, and use of urgent care after returning home, and contributed to the ways they engaged with information provided at discharge.
“Carers’ knowledge (e.g., health literacy, the patient’s care needs) was linked to their experience of carer burden, and use of urgent care after returning home, and contributed to the ways they engaged with information provided at discharge [43, 44, 57, 59, 60, 64, 66, 67].”
From Do hospital-to-home transitions work for older adults with multiple long-term conditions including dementia? A realist review (2025) · cites this paper as [67]
Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measuredLack of training and unpreparedness was linked to emotional distress in carers and increased hospital readmissions for patients when care needs were unmet.
“Subsequently, this was linked to emotional distress in carers, and increased hospital readmissions for patients when care needs were unmet (CMOC27) [44, 46, 47, 53, 67].”
From Do hospital-to-home transitions work for older adults with multiple long-term conditions including dementia? A realist review (2025) · cites this paper as [67]
The Results describe caregivers’ risk of burnout, and the Discussion reports that many patients and caregivers felt overwhelmed during hospitalization. The Introduction notes a high rate of potentially avoidable rehospitalizations among patients with a major neurocognitive disorder. But the paper does not link lack of caregiver training or unpreparedness to distress, or unmet care needs to increased readmissions. (LLM, conf=0.84)
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“Subsequently, this was linked to emotional distress in carers, and increased hospital readmissions for patients when care needs were unmet (CMOC27) [44, 46, 47, 53, 67].”
- Authors
- Provencher, V., Viscogliosi, C., Lacerte, J., D’Amours, M., Mailhot-Bisson, D., Gagnon, L., & Lacombe, G.
- Affiliations
- Université de Sherbrooke (CA)
- Centre de recherche sur le vieillissement (CA)
- Research Centre on Aging, Sherbrooke, Canada
- Corresponding author
- Provencher, Véronique
- Venue
- Journal of Patient Experience
- Publisher
- SAGE Publications
- Published
- 2024-01
- Volume
- 11
- Pages
- 23743735241259553-23743735241259553
- ISSN
- 2374-3735 (ISSN-L)
- 2374-3743
- PMC
- PMC11301727
- OpenAlex
- W4401341900
- Cited by
- 3
- References
- 25
- Citations by year
- 2026: 2 · 2025: 1
- FWCI
- 0.88
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Journal of Patient Experience (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Funders
- Alzheimer Society Research Program (Application Number 16-16)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Emergency Medicine › Hospital Admissions and Outcomes
- Health Sciences › Health Professions › General Health Professions › Geriatric Care and Nursing Homes
- Keywords
- hospital-to-home transition, risk management, major neurocognitive disorder, dementia, caregivers, occupational therapists, patient experience, risk assessment, post-discharge care, adverse events
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