D. S. Swords1, S. L. Slager2, C. R. Weir2, B. S. Brooke1 1University Of Utah,Department Of Surgery,Salt Lake City, UT, USA 2University Of Utah,Department Of Biomedical Informatics,Salt Lake City, UT, USA
Introduction: Episodes of care for surgical patients involve multiple transitions between different healthcare settings and providers. While it is recognized that care coordination is often fragmented during transitions of surgical care, it is not clear how this specifically impacts surgical patients and their caregivers. This study was designed to identify themes that define care coordination from patient and caregiver perspectives’ during transitions of surgical care.
Methods: We performed a cross-sectional qualitative study using transcripts obtained from eight focus group sessions conducted among patients and caregivers from 3 different US states who had recently experienced an episode of surgical care. We used Atlas.ti qualitative software and engaged in an iterative process of thematic analysis of the focus group transcripts among three independent reviewers.
Results: A total of 114 patients and caregivers were interviewed during focus group sessions who had been exposed to a broad range of different surgical procedures and specialties. After five-rounds of thematic analysis using focus group transcripts, we identified 5 main themes that commonly define care coordination for patients and caregivers during transitions of surgical care: 1) Care coordination is embedded in the unwritten social contract patients share with their healthcare providers; 2) Patients expect that all healthcare providers will be on the same page with each other; 3) Patients are frightened and vulnerable during surgical transitions; 4) Patients want providers to help set accurate expectations of their care processes; and 5) Care coordination relies upon mutual trust between patients and their healthcare providers, which needs to be established and reaffirmed throughout the episode of care (Table).
Conclusion: Surgical patients and their caregivers expect healthcare providers to engage in comprehensive communication processes to avoid fragmented care coordination during transitions of surgical care. Improving care coordination will require better informatics infrastructure, patient education materials and information exchange between providers. These findings have implications for designing patient-centered interventions to improve coordination of care for surgical patients.
