Older Persons' Transitions in Care (OPTIC): a study protocol.
BMC Geriatrics · 2012-12-14 · Observational study
Abstract
BACKGROUND: Changes in health status, triggered by events such as infections, falls, and geriatric syndromes, are common among nursing home (NH) residents and necessitate transitions between NHs and Emergency Departments (EDs). During transitions, residents frequently experience care that is delayed, unnecessary, not evidence-based, potentially unsafe, and fragmented. Furthermore, a high proportion of residents and their family caregivers report substantial unmet needs during transitions. This study is part of a program of research whose overall aim is to improve quality of care for frail older adults who reside in NHs. The purpose of this study is to identify successful transitions from multiple perspectives and to identify organizational and individual factors related to transition success, in order to inform improvements in care for frail elderly NH residents during transitions to and from acute care. Specific objectives are to: 1. define successful and unsuccessful elements of transitions from multiple perspectives; 2. develop and test a practical tool to assess transition success; 3. assess transition processes in a discrete set of transfers in two study sites over a one year period; 4. assess the influence of organizational factors in key practice locations, e.g., NHs, emergency medical services (EMS), and EDs, on transition success; and 5. identify opportunities for evidence-informed management and quality improvement decisions related to the management of NH - ED transitions. METHODS/DESIGN: This is a mixed-methods observational study incorporating an integrated knowledge translation (IKT) approach. It uses data from multiple levels (facility, care unit, individual) and sources (healthcare providers, residents, health records, and administrative databases). DISCUSSION: Key to study success is operationalizing the IKT approach by using a partnership model in which the OPTIC governance structure provides for team decision-makers and researchers to participate equally in developing study goals, design, data collection, analysis and implications of findings. As preliminary and ongoing study findings are developed, their implications for practice and policy in study settings will be discussed by the research team and shared with study site administrators and staff. The study is designed to investigate the complexities of transitions and to enhance the potential for successful and sustained improvement of these transitions.
Abstract © the authors or publisher, via PubMed. Reuse and removal
Tags
Nursing & care homes · Communication & handover · Older adults · Patient experience
Related articles
- Stakeholder perspectives on transitions of nursing home residents to hospital emergency departments and back in two Canadian provinces. (J Aging Stud, 2012)
- Barriers to healthy transitions between nursing homes and emergency departments. (Geriatr Nurs, 2024)
- Entrusting life to professionals: A phenomenological hermeneutical study of older persons' participation in prehospital emergency care involving municipal home care and ambulance services. (Scand J Caring Sci, 2024)
- Fractured Care: A Window Into Emergency Transitions in Care for LTC Residents With Complex Health Needs. (J Aging Health, 2020)
- The Older Persons' Transitions in Care (OPTIC) study: pilot testing of the transition tracking tool. (BMC Health Serv Res, 2013)
- Understanding potentially avoidable emergency department visits in older adults: a survey with healthcare professionals across in- and outpatient care in Sweden. (BMJ Open, 2026)