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  • Transitional care quality indicators to assess quality of care following hospitalisation for chronic obstructive pulmonary disease and heart failure: a systematic review protocol

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Evidence based practice
Protocol
Transitional care quality indicators to assess quality of care following hospitalisation for chronic obstructive pulmonary disease and heart failure: a systematic review protocol
  1. Faith Michael1,
  2. Sera Whitelaw2,
  3. Harriette GC Van Spall2,3,4
  1. 1 Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
  2. 2 Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
  3. 3 Population Health Research Institute, Hamilton, Ontario, Canada
  4. 4 Department of Medicine, McMaster University, Hamilton, Ontario, Canada
  1. Correspondence to Dr Harriette GC Van Spall; Harriette.VanSpall{at}phri.ca

Abstract

Introduction The period following hospitalisation for chronic obstructive pulmonary disease (COPD) or heart failure (HF)—when patients transition between settings and clinicians—is one of high risk. Transitional care services that bridge the gap from hospital to home can improve outcomes, but there are no widely accepted indicators to assess their quality.

Methods and analysis In this systematic review, we will summarise transitional care quality indicators, and describe their associations with clinical, patient-reported and cost outcomes. We will search MEDLINE, Embase, CINAHL and HealthSTAR, as well as grey literature and reference lists of included articles. We will screen all studies published between January 1990 and October 2019 that test an intervention that aims to improve the hospital-to-home transition for patients with COPD and/or HF; and measure at least one process (eg, medication errors), clinical (eg, hospital readmissions) or patient-reported (eg, health-related quality of life) outcome which will serve as a transitional care quality indicator . We will include randomised controlled trials, cohort studies, cross-sectional studies, interrupted time series studies and before–after studies. We will extract data in duplicate and classify transitional care quality indicators as structural, process-related or outcome-related. When possible, we will assess associations between transitional care quality indicators and clinical outcomes. In anticipation of conceptual and statistical heterogeneity, we will provide a qualitative synthesis and narrative review of the results.

Ethics and dissemination This review will provide a list of transitional care quality indicators and their associations with clinical outcomes. These results can be used by hospitals, administrators and clinicians for assessing the quality of transitional care provided to patients with COPD and HF. The findings can also be used by policy-makers to assess and incentivise transitional care quality. We will disseminate results through publications, social media releases and presentations.

PROSPERO registration number This study is registered on PROSPERO.

  • transitional care
  • heart failure
  • COPD
  • assessing performance
  • quality indicators

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjopen-2019-032764

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    Footnotes

    • Contributors HGCV obtained funding, conceived the research question and study design, informed the search strategy and analytic plan, and drafted and edited the manuscript. FM contributed to the search strategy, extracted data, and drafted and edited the manuscript. SW extracted data, and drafted and edited the manuscript. All authors read and approved the final manuscript.

    • Funding This research is funded by a grant from the Ontario’s Ministry of Health and LongTerm Care (MOHLTC). HGCV receives support from the MOHLTC’s Health System Research Fund and Hamilton Health Sciences Early Career Award.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.