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Understanding experiences of patients and family caregivers in the Mayo Clinic Care Transitions program: a qualitative study

Authors Takahashi PY, Finnie DM, Quigg SM, Borkenhagen LS, Kumbamu A, Kimeu AK, Griffin JM

Received 14 August 2018

Accepted for publication 10 October 2018

Published 19 December 2018 Volume 2019:14 Pages 17—25

DOI https://doi.org/10.2147/CIA.S183893

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 3

Editor who approved publication: Dr Richard Walker


Paul Y Takahashi,1 Dawn M Finnie,2 Stephanie M Quigg,1 Lynn S Borkenhagen,1 Ashok Kumbamu,2 Ashley K Kimeu,1 Joan M Griffin2,3

1Department of Internal Medicine, Division of Primary Care Internal Medicine, Mayo Clinic, Rochester, MN, USA; 2Robert D and Patricia E Kern Center for Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA; 3Department of Health Science Research, Division of Health Care Policy and Research, Mayo Clinic, Rochester, MN, USA

Background: Care transitions programs are increasingly used to improve care and reduce re-admission of patients after hospitalization. To learn from the experience of patients who have participated in the Mayo Clinic Care Transitions (MCCT) program and to understand the patient experience, we sought perspectives of patients, caregivers, and providers who worked with participants of the MCCT program.
Methods: Investigators interviewed 17 patients and nine of their caregivers about their experience with the MCCT program. Eight health care providers described provider experiences with the MCCT program. Data from semistructured interviews were audio recorded, transcribed, and evaluated through content analysis. Inductive coding methods were used to elicit themes about patient experience with the MCCT program.
Results: Patients, caregivers, and providers emphasized that the MCCT program prevented hospitalizations and contributed to the health and quality of life of participants. All three stakeholder groups emphasized the value of the home visit and provision of the visit on a patient’s “home turf” as central to the program. Patients appreciated speaking to a provider without the stress and exertion of a trip to the clinic. Caregivers appreciated improved communication provided in the home visit and felt that home visits gave them peace of mind. Patients, caregivers, and providers also identified the need for improved phone triage and communication.
Conclusion: Patients, caregivers, and providers acknowledged the care transitions problem and emphasized the benefits of seeing patients on their home turf rather than in an office visit. This qualitative study of patient, caregiver, and provider experiences further validates the importance of the MCCT program.

Keywords: geriatrics, home care, program evaluation, nurse practitioner, hospitalization

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