ORIGINAL ARTICLE
Moving from place to place in the last year of life: A qualitative study identifying care setting transition issues and solutions in Ontario
Donna M. Wilson RN, PhD,
Stephen Birch DPhil,
Corresponding Author
Donna M. Wilson RN, PhD
Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
Department of Nursing and Midwifery, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland
Correspondence
Donna M. Wilson, Faculty of Nursing, University of Alberta, Edmonton, AB, Canada.
Email: [email protected]
Search for more papers by this authorStephen Birch DPhil
Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, ON, Canada
Search for more papers by this authorDonna M. Wilson RN, PhD,
Stephen Birch DPhil,
Corresponding Author
Donna M. Wilson RN, PhD
Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
Department of Nursing and Midwifery, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland
Correspondence
Donna M. Wilson, Faculty of Nursing, University of Alberta, Edmonton, AB, Canada.
Email: [email protected]
Search for more papers by this authorStephen Birch DPhil
Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, ON, Canada
Search for more papers by this authorAbstract
Moving from one care setting to another is common as death nears. Many concerns exist over these end-of-life (EOL) care setting transitions, including low-quality moves as mistakes and other mishaps can occur. Delayed or denied moves are also problematic, such as a move out of hospital for dying inpatients who want to spend their last hours or days at home. The aim of the study was to identify current issues or problems with care setting transitions during the last year of life as well as potential or actual solutions for these problems. A grounded theory analysis approach was used based on interviews with 38 key informants who represent a wide range of healthcare providers, healthcare managers, government representatives, lawyers, healthcare recipients and their family/friends across Ontario in 2016. Three interrelated themes were revealed: (a) communication complexities, (b) care planning and coordination gaps and (c) health system reform needs. Six solutions were highlighted, with these designed to prevent care setting transition issues and monitor care setting transitions for continued improvements.
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