Unpacking the dynamics of transitional care units in Ontario, Canada

剖析加拿大安大略省过渡护理单元的运作机制

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Abstract

BACKGROUND AND OBJECTIVES: Transitional care units (TCUs) provide short-term, low-intensity, restorative care to patients who are medically stable but unable to leave the hospital due to factors, such as lack of support. In Ontario, Canada, TCUs have been implemented over the past decade, yet little is known about their operation. This study aimed to explore the structural characteristics and the care processes of TCUs from the perspective of TCU managers. RESEARCH DESIGN AND METHODS: An exploratory descriptive qualitative design was employed. Semi-structured interviews were conducted with seven TCU managers. A five-step inductive thematic analysis was used to identify themes. Participants' median age was 46 years (range 36-50), with four men and three women. Their experience as TCU managers at the time of the interview ranged from 2 months to 5 years. RESULTS: The study results suggest variation across TCUs in terms of structure and patient populations served. Four themes were identified related to the care processes across seven TCUs: (1) ensuring safe transitions; (2) managing patients' expectations; (3) creating a team that works together; and (4) navigating a constantly changing environment. DISCUSSION AND IMPLICATIONS: Taking into account the variability of models, implementation and evaluation of these programs require careful planning. The complex medical and psychosocial needs of TCU patients should be considered when designing these units to ensure effective and appropriate care delivery.

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