Care Transition From the Emergency Department to Home for Patients With Coronary Artery Disease: A Grounded Theory Study

BACKGROUND: The discharge of a patient from the emergency department marks a critical transition of care. Effective care transitions are essential components of integrated healthcare delivery and play a vital role in the management of care for patients with chronic conditions such as coronary artery disease. The purpose of this study was to explore the process of care transition from the emergency department to home for patients with coronary artery disease. METHODS: A grounded theory approach, as outlined by Corbin and Strauss, was used. Data were collected from observational field notes and individual semi-structured interviews conducted with 12 patients, 7 nurses, 3 family caregivers and 1 physician. Participants were selected using purposeful and theoretical sampling between April 2022 and August 2024 in an emergency department of a hospital in Iran. The coding and categorization processes were facilitated using MAXQDA software. FINDINGS: Data analysis yielded five major categories, 14 categories, and 48 subcategories. The primary concern of participants during the care transition from the emergency department to home was 'worrying about resolving homecare problems'. To overcome this, three strategies were employed by the patients: 'help seeking and supportive resources', 'increasing care information', and 'adherence to healthcare advice'. These strategies led to 'relative stability in health status' as the consequence of this process. 'Persistence and resourcefulness for recovery from coronary artery disease' was identified as the core category. CONCLUSIONS: Healthcare providers and managers should develop strategies focused on the provision of support and resources to enhance the quality and safety of transitional care for patients with coronary artery disease discharged home from the emergency department.