Older adults identified four main barriers during ED-to-community transitions: abrupt discharge processes, challenges navigating outpatient follow-up, new physical limitations, and caregiver impacts.
Older adults face significant barriers during ED-to-community transitions, including abrupt discharges and difficulties navigating follow-up care, highlighting areas for targeted interventions.
BACKGROUND: Over one-half of older adults are discharged to the community after emergency department (ED) visits, and studies have shown there is increased risk of adverse health outcomes in the immediate post-discharge period. Understanding the experiences of older adults during ED-to-community care transitions has the potential to improve geriatric emergency clinical care and inform intervention development. We therefore sought to assess barriers experienced by older adults during ED-to-community care transitions. METHODS: We conducted a qualitative analysis of community-dwelling cognitively intact patients aged 65 years and older receiving care in four diverse EDs from a single U.S. healthcare system. We constructed a conceptual framework a priori to guide the development and iterative revision of a codebook, used purposive sampling, and conducted recorded, semi-structured interviews using a standardized guide. Two researchers coded the professionally transcribed data using a combined deductive and inductive approach and analyzed transcripts to identify dominant themes and representative quotations. RESULTS: Among 25 participants, 20 (80%) were women and 17 (68%) were white. We identified four barriers during the ED-to-community care transition: (1) ED discharge process was abrupt with missing information regarding symptom explanation and performed testing, (2) navigating follow-up outpatient clinical care was challenging, (3) new physical limitations and fears hinder performance of baseline activities, and (4) major and minor ramifications for caregivers impact an older adult's willingness to request or accept assistance. CONCLUSIONS: Older adults identified barriers to successful ED-to-community care transitions that can inform the development of novel and effective interventions.
Gettel et al. (Sat,) conducted a other in Emergency department-to-community care transitions (n=25). Emergency department-to-community care transitions was evaluated on Barriers experienced during ED-to-community care transitions. Older adults identified four main barriers during ED-to-community transitions: abrupt discharge processes, challenges navigating outpatient follow-up, new physical limitations, and caregiver impacts.