Medication safety during care transitions is a significant challenge, especially for older adults prescribed multiple medications. Using a systems approach to understand barriers to and strategies for safe medication management throughout high-risk periods of hospital-to-home transition is one important step in designing effective interventions. Framing the care transition as a collaboration between healthcare and patient “work systems,” we conducted semi-structured interviews with 37 clinical team members, representing 10 different professional roles involved in providing transitional care for patients. Thematic analyses identified key strategies used by clinical team members in preparing patients to self-manage medications safely in the home environment: (1) streamlining and coordinating clinical management of medication reconciliation across care settings; (2) building patient capacity and engagement in self-management of medications; and (3) redesigning the transitional process. Our research highlights the value in aligning professionals’ care transition goals with patients and caregiver(s) to better prepare them to self-manage medications upon discharge.

护理过渡期间的药物安全是一个重大挑战，特别是对于服用多种药物的老年人而言。使用系统方法来了解从医院到家庭过渡的高风险期安全药物管理的障碍和策略是设计有效干预措施的重要一步。我们将护理过渡视为医疗保健和患者“工作系统”之间的协作，对 37 名临床团队成员进行了半结构化访谈，他们代表了为患者提供过渡护理的 10 个不同专业角色。主题分析确定了临床团队成员在准备患者在家庭环境中安全地自我管理药物时使用的关键策略：（1）简化和协调跨护理机构药物协调的临床管理；(2) 培养患者自我管理药物的能力和参与度；(3) 重新设计过渡流程。我们的研究强调了将专业人员的护理过渡目标与患者和护理人员结合起来的价值，以更好地让他们做好出院后自我管理药物的准备。