Exploring success in sub-acute hospital-to-home transitions for palliative patients: a descriptive qualitative study
Bibliographic record
Abstract
BACKGROUND: Transitioning from a sub-acute hospital to home is highly desirable to some palliative and end-of-life individuals and their family caregivers, but the transition process itself is complex and can be logistically challenging. This formative assessment sought to better understand what constitutes a successful sub-acute hospital-to-home transition from the perspectives of health care providers connected to a sub-acute care facility in Ottawa, Canada, with reflections from a patient and a family caregiver. METHODS: Our descriptive qualitative study involved 13 virtual interviews and one virtual focus group between February and May 2023. Our sample included health care providers involved in the sub-acute hospital-to-home transition for palliative patients from a sub-acute facility, as well as one patient and one family caregiver who had experienced a palliative transition in this context. We used reflexive thematic analysis to code the data, and we inductively developed themes based on participants' experiences. RESULTS: We collected data from 14 health care providers, one patient, and one family caregiver who were involved in, or had experienced, a sub-acute hospital-to-home transition. We found three themes delineating participants' shared perceptions of the key foundations of a successful sub-acute hospital-to-home transition in the palliative context: meeting patient goals; sharing information to ensure informed decision-making; and having someone to coordinate the transition. CONCLUSIONS: Our study highlighted that a successful sub-acute hospital-to-home transition should be person-centred and requires effective communication and coordination, both within and across, hospital and home environments. These insights will help inform intervention co-design to improve palliative care transitions in the next phase of this project.
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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 | 0.022 | 0.034 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.011 | 0.012 |
| Scholarly communication | 0.005 | 0.006 |
| Open science | 0.003 | 0.006 |
| Research integrity | 0.002 | 0.003 |
| 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".