TY - JOUR
T1 - Challenges and improvements associated with transitions between hospitals and care homes during the Covid-19 pandemic
T2 - a qualitative study with care home and healthcare staff in England
AU - Newman, Craig
AU - Mulrine, Stephanie
AU - Brittain, Katie
AU - Dawson, Pamela
AU - Mason, Celia
AU - Spencer, Michele
AU - Sykes, Kate
AU - Underwood, Frazer
AU - Young-Murphy, Lesley
AU - Waring, Justin
AU - Scott, Jason
N1 - Funding information: This work was supported by The Dunhill Medical Trust [grant number RPGF2006\226]. We acknowledge the National Institute for Health Research (NIHR) Applied Research Collaboration North East and North Cumbria (Multimorbidity, Ageing and Frailty theme), the NIHR Clinical Research Network (CRN) and the NIHR Enabling Research in Care Homes (ENRICH) network. Thank you to everyone who supported recruitment and took part in the study.
PY - 2023/9
Y1 - 2023/9
N2 - BACKGROUND: Care home residents transitioning from hospital are at risk of receiving poor-quality care with their safety being challenged by the SARS-CoV-2 virus (COVID-19) pandemic. Little is known about how care home staff worked with hospital staff and other healthcare professionals to address these challenges and make improvements to increase patient safety. OBJECTIVE: To gain insight into how the COVID-19 pandemic influenced the safety of transitions between hospital and care home. METHOD: Semi-structured interviews were conducted with care home staff and healthcare professionals involved in hospital to care home transitions including doctors, nurses, paramedics, pharmacists, social workers, and occupational therapists. Commonalities and patterns in the data were identified using thematic analysis. RESULTS: Seventy participants were interviewed. Three themes were developed, first, 'new challenges', described care homes were pressurised to receive hospital patients amidst issues with COVID-19 testing, changes to working practices and contentious media attention, which all impacted staff negatively. Second, 'dehumanisation' described how care home residents were treated, being isolated from others amounted to feelings of being imprisoned, caused fear and engendered negative reactions from families. Third, 'better ways of working' described how health and social care workers developed relationships that improved integration and confidence and benefited care provision. CONCLUSION: The COVID-19 pandemic contributed to and compounded high-risk hospital-to-care home discharges. Government policy failed to support care homes. Rapid discharge objectives exposed a myriad of infection control issues causing inhumane conditions for care home residents. However, staff involved in transitions continued to provide and improve upon care provision.
AB - BACKGROUND: Care home residents transitioning from hospital are at risk of receiving poor-quality care with their safety being challenged by the SARS-CoV-2 virus (COVID-19) pandemic. Little is known about how care home staff worked with hospital staff and other healthcare professionals to address these challenges and make improvements to increase patient safety. OBJECTIVE: To gain insight into how the COVID-19 pandemic influenced the safety of transitions between hospital and care home. METHOD: Semi-structured interviews were conducted with care home staff and healthcare professionals involved in hospital to care home transitions including doctors, nurses, paramedics, pharmacists, social workers, and occupational therapists. Commonalities and patterns in the data were identified using thematic analysis. RESULTS: Seventy participants were interviewed. Three themes were developed, first, 'new challenges', described care homes were pressurised to receive hospital patients amidst issues with COVID-19 testing, changes to working practices and contentious media attention, which all impacted staff negatively. Second, 'dehumanisation' described how care home residents were treated, being isolated from others amounted to feelings of being imprisoned, caused fear and engendered negative reactions from families. Third, 'better ways of working' described how health and social care workers developed relationships that improved integration and confidence and benefited care provision. CONCLUSION: The COVID-19 pandemic contributed to and compounded high-risk hospital-to-care home discharges. Government policy failed to support care homes. Rapid discharge objectives exposed a myriad of infection control issues causing inhumane conditions for care home residents. However, staff involved in transitions continued to provide and improve upon care provision.
KW - COVID-19
KW - care home
KW - care transitions
KW - hospital discharge
KW - older people
KW - qualitative research
UR - http://www.scopus.com/inward/record.url?scp=85168100733&partnerID=8YFLogxK
U2 - 10.1093/ageing/afad146
DO - 10.1093/ageing/afad146
M3 - Article
C2 - 37740896
SN - 0002-0729
VL - 52
JO - Age and Ageing
JF - Age and Ageing
IS - 9
M1 - afad146
ER -
