Patient engagement in the development of best practices for transitions from hospital to home: a scoping review

Grace Zhao; Carol Kennedy; Gracia Mabaya; Karen Okrainec; Tara Kiran

doi:10.1136/bmjopen-2019-029693

Patient engagement in the development of best practices for transitions from hospital to home: a scoping review

BMJ Open. 2019 Aug 5;9(8):e029693. doi: 10.1136/bmjopen-2019-029693.

Authors

Grace Zhao¹, Carol Kennedy², Gracia Mabaya², Karen Okrainec³, Tara Kiran^{2

4

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Affiliations

¹ MD Program, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
² Quality Standards, Evidence Development and Standards, Health Quality Ontario, Toronto, Ontario, Canada.
³ Department of Medicine, University Health Network and University of Toronto, Toronto, Ontario, Canada.
⁴ Department of Family and Community Medicine, St. Michael's Hospital and University of Toronto, Toronto, Ontario, Canada.
⁵ Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Toronto, Ontario, Canada.

Abstract

Objectives: To explore the extent of patient engagement in the development of best practice reports related to transitions from hospital to home.

Design: Scoping review.

Data sources: Electronic databases (MEDLINE, EMBASE, CINAHL, Scopus, Trip Database, DynaMed Plus and Public Health Plus) and multiple provincial regulatory agency and healthcare organisation websites.

Eligibility criteria: We included best practice reports related to the transition from hospital to a long-term care facility, community dwelling or rehabilitation centre. We included documents disseminated in English between 1947 and 2019.

Data extraction and synthesis: Two independent reviewers screened for eligibility and one extracted and analysed data using a data extraction tool we developed based on established patient engagement frameworks. Only records actively engaging patients were analysed (n=11). The methodological quality of actively engaging patients was assessed using domain 2 (item 5) of stakeholder involvement from the Appraisal of Guidelines for Research and Evaluation II (AGREE II) tool.

Results: The search yielded 1921 citations of which 23 met the inclusion criteria and were included for narrative synthesis. These were disseminated between 1995 and 2019, with 18 (78%) published after 2010. Most were conducted in North America (USA 43%, Canada 22%), Europe (UK 30%) and Australia (4%). Eleven (48%) actively involved patients, of which only two involved patients across all stages of development. Most involved patients through direct or indirect consultation. The mean AGREE II domain 2 item 5 score (of those that actively engaged patients) was 5.9 out of 7.

Conclusions: Only half of existing best practice reports related to the transition from hospital to home actively involved patients in report development. However, the extent of patient engagement has been increasing over time. More organisations should strive to engage patients throughout the best practice development process and provide patients with opportunities for shared leadership.

Keywords: best practices; patient engagement; quality in health care; transitions of care.

Publication types

Research Support, Non-U.S. Gov't
Review

MeSH terms

Humans
Long-Term Care
Patient Discharge*
Patient Participation*
Rehabilitation Centers
Transitional Care*