Transition in care is an imperative period for both the patient and the medical practitioners given the wide array of issues that have to be put under consideration to ensure that the transition is smooth and devoid of any complications ( Brown, 2018) . The transfer of patients between healthcare professionals is bound to occur either between different locations or between different levels of care in a facility where a patient is admitted to. For transitional care to be swift and efficient there is a need for medical professionals to be adequately trained in the administration of care together with being updated with the patient’s goals ( Finlayson, et al., 2018) .
Additionally, transitions in care encompasses ensuring that the new health care professional is acquainted with the personal preferences of a patient coupled with the being updated on the clinical status of the patient ( Brown, 2018) . Managing transition of care from primary care to hospice care and vice versa is critical given the fact that research has identified this as a high risk area as far as the administration of care is concerned ( Brown, 2018) . Some of the issues associated with transition in care include increased mortality rates, increase in morbidity in addition to delays in the reception, unnecessary readmissions to healthcare facilities, and issuance of the recommended care and support among a wide array of issues ( Finlayson, et al., 2018) .
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Components of PICOT Question
In older patients transferred between health care sectors (P) what is the effect of transition in care between primary care and hospice care (I) on the reduction of preventable readmissions to hospital (O) compared to the absence of transitions in care (C) within a one-year period (T)?
(P) -Older patients have been identified as having greater risks of falling victim to the loopholes and failures of transitions in health care and treatment given the wide array of risk factors that the older individuals in society are susceptible to for instance complex health issues ( Rustad, et al., 2016) .
(I) – the lack of proper transition is likely to result in unnecessary readmission of patients given the fact that poor communication of clinical status together with progress made and medication administered may lead to diagnosis and readmission that would be unnecessary ( Finlayson, et al., 2018) .
(C) – the intervention is compared with the lack of implementation of transition in care in the administration of health services.
(O) – poor transition in care is likely to result in the readmission of individuals due to poor communication of diagnosis, medication, or treatment that has been administered or recommended.
(T) – one year is appropriate to effectively analyze the effect of transitions in care on the readmission of individuals among other factors that could also contribute.
Expansion of PICOTS Question
I have full access of statistics concerning the admission, discharge and readmission of older individuals. Moreover, it is possible to develop an intervention to ensure that transition in care is effected for instance ensuring that patients are appropriately discharged with the necessary and accurate information pertaining the state of their health ( Finlayson, et al., 2018) . A problem that is likely to occur include the adherence to the time schedule given the bureaucracy involved in the acquisition of patient records from public health facilities.
Summary
Transitions in care are vital given the fact that the adoption of transition strategies play a significant role in the alleviation of the wide array of risk factors associated with transition in care including mortality rates ( Le Berre et al., 2016) . Transition in care therefore critically aids in the ability of facilities and health care providers to establish patient centered care that is committed to ensure that the welfare of the patient is prioritized in the administration of healthcare services ( Le Berre et al., 2016) . Moreover, transition in care is vital given the fact that significant economic and social resources are saved through the adoption of transitions in care for instance the prevention of duplicate diagnosis and treatment ( Comans et al., 2016) . The administration of transition in care is both achievable and can be enhanced through research to enhance methods to be used for transition in healthcare. This is a quality improvement project given the fact that it is concerned about reducing the adverse effects of the lack of transition in care especially among older adults.
References
Brown, M. M. (2018). Transitions of care. In Chronic Illness Care (pp. 369-373). Springer, Cham.
Comans, T. A., Peel, N. M., Hubbard, R. E., Mulligan, A. D., Gray, L. C., & Scuffham, P. A. (2016). The increase in healthcare costs associated with frailty in older people discharged to a post-acute transition care program. Age and ageing , 45 (2), 317-320.
Finlayson, K., Chang, A. M., Courtney, M. D., Edwards, H. E., Parker, A. W., Hamilton, K., ... & O’Brien, J. (2018). Transitional care interventions reduce unplanned hospital readmissions in high-risk older adults. BMC health services research , 18 (1), 956.
Le Berre, M., Maimon, G., Sourial, N., Guériton, M., & Vedel, I. (2017). Impact of transitional care services for chronically ill older patients: a systematic evidence review. Journal of the American Geriatrics Society , 65 (7), 1597-1608.
Rustad, E. C., Furnes, B., Cronfalk, B. S., & Dysvik, E. (2016). Older patients’ experiences during care transition. Patient preference and adherence , 10 , 769.
