Supporting resident-centred decision-making about transitions from long-term care homes to hospital: a qualitative study protocol

• Published in: BMJ open 2024-11, Vol.14 (11), p.e086748
• Main Authors: Ménard, Alixe, Konikoff, Lauren, Adams, Michaela, Singh, Yamini, Scott, Mary M, Yin, Christina Y, Kimura, Maren, Kobewka, Daniel, Fung, Celeste, Isenberg, Sarina R, Kaasalainen, Sharon, Kierulf, Jackie, Molnar, Frank, Shamon, Sandy, Wilson, Kumanan, Kehoe MacLeod, Krystal
• Format: Article
• Language: English
• Subjects: Aging in place; Canada Health Act; Decision Making; Geriatric Medicine; Hospitals; Humans; Interviews as Topic; Long term health care; Long-Term Care; Needs Assessment; Nursing Homes - organization & administration; Older people; Ontario; Patient Transfer; Patient-Centered Care; Pressure ulcers; Protocol; Qualitative Research; Research Design; Retirement homes; Workloads
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2024-086748

Burdensome care transitions may occur despite clinicians' engagement in care planning discussions with residents and their family/friend care partners. Conversations about potential hospital transfers can better prepare long-term care (LTC) residents, their families and care providers for future decision-making. Lack of such discussions increases the likelihood of transitions that do not align with residents' values. This study will examine experiences of LTC residents, family/friend care partners and staff surrounding decision-making about LTC to hospital transitions and codesign a tool to assist with transitional decision-making to help prioritise needs and preferences of residents and their care partners. This study will use semi-structured needs assessment interviews (duration: 1 hour), content analysis of existing decision support and discussion tools and a codesign workshop series (for residents and care partners, and for staff) at three participating LTC home research sites. This qualitative work will inform the development of a decision support tool that will subsequently be pilot tested and evaluated at three partnering LTC homes in future phases of the project. The study is guided by the Person-centred Practice in Long-term Care theoretical framework. Interview audio recordings will be transcribed verbatim and analysed using reflexive thematic analysis. Participants will be recruited in partnership with three LTC homes in Ottawa, Ontario. Eligible participants will be English or French speaking residents, family/friend care partners or staff (eg, physicians, nurses and personal support workers) who have experienced or been involved in a transition from LTC to hospital. Ethical approval has been obtained from the Bruyère Health Research Ethics Board (#M16-23-030). Findings will be (1) reported to participating and funding organisations; (2) presented at national and international conferences and (3) disseminated by peer-review publications.