Barriers to an Effective and Efficient Intra- and Inter-Establishment Transfer of Elderly Patients in Healthcare: A Scoping Review
Bibliographic record
Abstract
Introduction: An estimated 80% of consequential medical oversights originate from communication errors during patient hand-offs between clinical providers during inter-facility transfer. During the transfer, patients are at risk of receiving low quality, fragmented care plagued with inadequate communication and coordination across settings. Effective and efficient inter-establishment transfers are thus pivotal to safeguard the quality of care received by patients, thereby optimizing patient outcomes. Methods: To inform the limited literature on the barriers to an effective and efficient intra- and inter-establishment transfer of elderly patients in health care, a scoping review specific to the geriatric context was undertaken. Searches of three electronic databases (MEDLINE, CINAHL, and Scopus) were conducted between 15th September to 1st November 2021. 18 peer-reviewed English-written articles published between 2011 and 2021 were included in this review. The Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) Checklist and Arksey and O’Malley’s (2005) methodological approach for scoping reviews informed the writing of this review. Results: This review identified a total of 18 articles that discussed barriers to an effective and efficient inter-establishment transfer of elderly patients in healthcare. Three categories of barriers: individual-level, healthcare provider-level, and organizational-level were identified. Discussion: In the current literature, most studies pertain to the transition of older patients from hospital to home, there is a dearth in research elucidating the barriers related to intra- and inter-facility transfer of elderly patients. Of the barriers that we found, communication barriers were present in all three levels: individual, healthcare provider, and organizational. Limitations are presented. Conclusion: This review found several areas that should be improved for safer care transitions of elderly patients between facilities. The efficient and effective intra- and inter-establishment transfer of elderly patients in health care is impeded by a range of barriers, most importantly a lack of communication, which is found in every three levels of barriers. By categorizing the barriers to an efficient and effective transition of elderly patients into three levels: individual, health professional, and organizational, this scoping review hopes to present current research in a structured way for future research.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.031 | 0.141 |
| Meta-epidemiology (narrow) | 0.002 | 0.002 |
| Meta-epidemiology (broad) | 0.005 | 0.007 |
| Bibliometrics | 0.020 | 0.020 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.006 | 0.006 |
| Open science | 0.002 | 0.003 |
| Research integrity | 0.004 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".