Background

Despite the breadth and diversity of research and policies on care transitions, research studies often report similar components that affect the quality and safety of care, including communication across professional groups and care settings, transfer of information, coordination of resources or training of healthcare personnel. In this article, we aim to deepen our understanding of care transitions by proposing a heuristic research framework that takes into account the components and factors influencing the quality and safety of care transitions in diverse settings.

Methodology

Using a pragmatic qualitative narrative meta-synthesis of empirically grounded research studies (N = 13) involving 31 researchers from seven countries (Australia, Canada, Denmark, Germany, the Netherlands, Norway and the UK), we conducted a thematic analysis to identify the components analysed in the included studies. We then used these components to create a framework for researching care transitions.

Results

Our narrative synthesis found that the quality and safety of care transitions are influenced by a range of patient-centred, communicative, collaborative, cultural, competency-based, accountability-based and spatial components. These components are encompassed within a broader set of dimensions that require careful consideration: (1) the conceptualising of the care transition notion, (2) the methodology for researching care transitions, (3) the role of patients and carers in care transitions, (4) the complexity surrounding care transitions, (5) the boundaries intertwined in care transitions and (6) care transition improvement interventions. These six dimensions constitute an analytical framework for planning and conducting research on care transitions in diverse settings.

Conclusion

The proposed six-dimensional framework for researching quality and safety in care transitions offers a roadmap for future practice and policy interventions and provides a starting point for planning and designing future research.

中文翻译：

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跨越边界：建立一个研究过渡阶段质量和安全性的框架。

背景

尽管有关护理过渡的研究和政策的广度和多样性，但研究报告通常报告会影响护理质量和安全的类似因素，包括跨专业团体和护理环境的交流，信息传递，资源协调或医护人员培训。在本文中，我们旨在通过提出启发式研究框架来加深对护理过渡的理解，该框架应考虑影响不同环境中护理过渡的质量和安全性的组件和因素。

方法

我们对来自七个国家（澳大利亚，加拿大，丹麦，德国，荷兰，挪威和英国）的31名研究人员进行了基于经验的研究（N = 13）的实用定性叙事元合成，我们进行了主题分析，以找出纳入研究中分析的成分。然后，我们使用这些组件创建了一个研究护理过渡的框架。

结果

我们的叙述性综合发现，护理过渡的质量和安全性受到一系列以患者为中心，沟通，协作，文化，能力，问责制和空间因素的影响。这些要素包含在一系列更广泛的维度中，需要仔细考虑：（1）护理过渡概念的概念化；（2）研究护理过渡的方法；（3）患者和护理人员在护理过渡中的作用；（ 4）护理过渡的复杂性，（5）护理过渡交织在一起的边界，以及（6）护理过渡改善干预措施。这六个维度构成了一个分析框架，用于规划和进行各种环境下的护理过渡研究。

结论

拟议的六维框架，用于研究护理过渡的质量和安全性，为将来的实践和政策干预提供了路线图，并为规划和设计未来的研究提供了起点。