Improving Transitional Care: The Role of Handoffs and Discharge Checklists in Hematologic Malignancies.

BACKGROUND: Transitional care from inpatient to outpatient settings is a high-risk time for medical errors and missed follow-up appointments. Discharge checklists and handoffs are effective tools that lead to improved quality of care and outcomes. OBJECTIVES: The purpose of this project was to implement an evidence-based discharge checklist and handoff template to improve and standardize transitional care from hospital to home for patients with hematologic malignancies. METHODS: The advanced practice providers (APPs) completed the discharge checklist at least 24 hours prior to discharge. The APPs requested appointments through the electronic health record using the discharge handoff tool. Chi-square analysis and descriptive statistics were used to analyze the data. FINDINGS: Implementation of the discharge checklist resulted in a statistically significant increase in the number of patients who had a follow-up appointment scheduled prior to discharge. The discharge handoff tool standardized communication between inpatient and outpatient providers.

A pilot study on the influence of an individualized and experiential training on cancer caregiver's self-efficacy in home care and symptom management.

The aim of this pilot study was to investigate if an individualized and experiential training can promote family caregiver's confidence (self-efficacy) in home care and symptom management. The study was conducted in a hematology/oncology unit in a southeastern regional medical center. Twenty informal cancer caregivers participated in the study. The individualized and experiential training was conducted at the bedside prior to patient's hospital discharge. Self-efficacy in home care and cancer symptom management was measured using the Cancer Caregiver Self-Efficacy Measure before and after training, and at 1 week after hospital discharge of cancer patients. Results of the study showed mean Cancer Caregiver Self-Efficacy Measure increased by 41.1 points immediately after the training (z = 4.49, p < 0.001) and was 31.7 points higher at 1-week follow-up (z = 3.22, p < 0.01). The findings of this study suggest that individualized and experiential training may be another avenue for nurses, including home care nurses, to support family home caregiving. By helping family members in home care, favorable patient outcomes may be achieved, enabling older patients with cancer to stay longer in the comfort of their homes.