Surgical transitional care interventions and their outcomes: a scoping review

Background: The few reviews available on surgical transitional care interventions focus on intervention effectiveness on readmissions, showing that transitional care interventions may reduce readmissions. More detailed guidance is needed for clinicians and researchers to adapt and implement these interventions and evaluate their effect. Objective: To identify, synthesise and map the evidence on surgical transitional care intervention components and surgical patient outcomes. Design: Scoping review. Methods: Medline, CINAHL and EMBASE were searched, followed by backward and forward citation searching. Two researchers independently screened titles and abstracts, and then full-texts. Data were extracted about study and intervention characteristics by one researcher, and checked for accuracy by a second researcher. To summarise the data, intervention components and outcome measures were categorised according to an existing list of transitional care intervention components and a core outcome set for perioperative patients, which were presented as tables, figures, and text. Results: Of 5176 articles found, 30 studies were included. Most studies focussed on cardiothoracic, general and orthopaedic surgery, and were primarily conducted in Asia and North America. Outcomes frequently measured were hospital readmissions, followed by health-related quality of life. Pre-discharge assessment, education and discharge planning, post-discharge telephone calls, and caregiver involvement were the most common intervention components. Generally, they demonstrated positive outcomes for hospital readmission and patient satisfaction. Conclusions: There is large focus on re-admission as an outcome measure, presenting an opportunity to explore a broader range of patient-centred and transition specific outcome measures. While common transitional care intervention components were uncovered, the evidence-base for each individual component is unclear. Gaps were found in surgical populations and settings, with most transitional care interventions focussing on cardiothoracic surgery across a limited geographic context, highlighting the opportunity to build the evidence-base for surgical transitional care interventions across a range of contexts. Review registration: The Open Science Framework (https://osf.io/kf2v7/).