Journal of the American Medical Directors Association · 2025
Qualitative Study of the Context of Health Information Technology in Sepsis Care Transitions: Facilitators, Barriers, and Strategies for Improvement.
СтатьяПоддержка исследования: вне правительства СШАПоддержка NIH: внешняя программаНазвание и аннотация: Перевод в очереди
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You Sang Bin, Hirschman Karen B, Stawnychy Michael A, Song Jiyoun, Sang Elaine, Pitcher Katherine, Oh Sungho, O'Connor Melissa, Garren Patrik, Bowles Kathryn H
Аннотация
OBJECTIVE: To examine how health information technology (HIT) supports timely post-acute home health and outpatient care for sepsis survivors by identifying facilitators, barriers, and proposed strategies.
DESIGN: Qualitative descriptive study.
SETTING AND PARTICIPANTS: Clinicians, care coordinators, sepsis coordinators, and administrators from 5 US health systems (hospitals and outpatient clinics) and affiliated home health care (HHC) agencies.
METHODS: We conducted semi-structured interviews, which were recorded, transcribed, and analyzed using thematic analysis with both deductive and inductive coding. Deductive coding was guided by the Consolidated Framework for Implementation Research to systematically assess barriers and facilitators of the intervention. The analysis achieved more than 90% interrater reliability, and member checking enhanced trustworthiness. After coding was finalized, a query was generated to identify electronic health record (EHR)-related themes that support or hinder health information management in electronic systems.
RESULTS: Sixty-one interviews with 91 participants identified 17 themes related to HIT's role in care transitions for sepsis survivors. HIT facilitated sepsis identification, documentation, communication, information sharing, care coordination, and quality monitoring during hospital-to-home transitions. Barriers included missing, delayed, or inaccessible information across disparate EHR systems. Proposed strategies include establishing interoperable EHR systems and leveraging HIT tools to improve identification, communication, and care coordination for timely follow-up care, with continuous monitoring of functionality.
CONCLUSIONS AND IMPLICATIONS: HIT plays a central role in care transitions, improving information sharing, communication, and coordination, ultimately enhancing patient outcomes and safety. Administrators can improve data integration and quality monitoring with interoperable systems, and policymakers can promote adoption through financial incentives. The advancement of technologies, including HIT tools, may offer opportunities to further optimize sepsis identification, communication, and care coordination, promoting seamless care transitions.
DESIGN: Qualitative descriptive study.
SETTING AND PARTICIPANTS: Clinicians, care coordinators, sepsis coordinators, and administrators from 5 US health systems (hospitals and outpatient clinics) and affiliated home health care (HHC) agencies.
METHODS: We conducted semi-structured interviews, which were recorded, transcribed, and analyzed using thematic analysis with both deductive and inductive coding. Deductive coding was guided by the Consolidated Framework for Implementation Research to systematically assess barriers and facilitators of the intervention. The analysis achieved more than 90% interrater reliability, and member checking enhanced trustworthiness. After coding was finalized, a query was generated to identify electronic health record (EHR)-related themes that support or hinder health information management in electronic systems.
RESULTS: Sixty-one interviews with 91 participants identified 17 themes related to HIT's role in care transitions for sepsis survivors. HIT facilitated sepsis identification, documentation, communication, information sharing, care coordination, and quality monitoring during hospital-to-home transitions. Barriers included missing, delayed, or inaccessible information across disparate EHR systems. Proposed strategies include establishing interoperable EHR systems and leveraging HIT tools to improve identification, communication, and care coordination for timely follow-up care, with continuous monitoring of functionality.
CONCLUSIONS AND IMPLICATIONS: HIT plays a central role in care transitions, improving information sharing, communication, and coordination, ultimately enhancing patient outcomes and safety. Administrators can improve data integration and quality monitoring with interoperable systems, and policymakers can promote adoption through financial incentives. The advancement of technologies, including HIT tools, may offer opportunities to further optimize sepsis identification, communication, and care coordination, promoting seamless care transitions.