Systematic review of contemporary improvement interventions on care coordination, discharge support and transitional care from the patient experience perspective

Abstract

AbstractAimTo synthesize the impact of improvement interventions related to care coordination and discharge support on patient experience measures.MethodSystematic review. Searches were completed in six scientific databases, five specialty journals and through snowballing. Eligibility included studies in English (2015-2022) on improving care coordination, discharge support, or transitional care assessed by standardized patient experience measures as a primary outcome. Two independent reviewers made eligibility decisions and performed quality appraisals.ResultsOf 1087 papers initially screened, 15 were finally included. Seven studies (three randomized controlled trials [RCTs]) focused on care coordination activities and used enhanced supports (e.g., improvement coaching; tailoring for vulnerable populations) for Patient-Centered Medical Homes or other primary care sites. Effectiveness was mixed or neutral relative to standard supports or models of care. Eight studies (three RCTs) focused on enhanced discharge support, including patient education (e.g., “teach back” method) and telephone follow-up or transitional support; mixed or neutral results on the patient experience were also found and with more substantive risks of bias.ConclusionEnhanced supports for improving care coordination, discharge education, and post-discharge follow-up had mixed or neutral effectiveness for improving the patient experience with care, compared to standard or simpler improvement approaches. Studies on the improvement of patient experiences, especially for enhanced patient discharge, need further strengthening such as including the patient perspective for its co-development.