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Transfer Between Hospitals Is a Risk Situation for Patients After Lung Cancer Surgery
Trine Oksholm1, Tone Rustoen, Mirjam Ekstedt
1Author Affiliations: VID Specialized University, Bergen, and Department of Respiratory Medicine, Oslo University Hospital (Dr Oksholm); Division of Emergencies and Critical Care, Oslo University Hospital, and Department of Nursing Science, Institute of Health and Society, University of Oslo (Dr Rustoen); and Centre for Shared Decision Making and Collaborative Care Research, Oslo University Hospital (Dr Ekstedt), Norway; and Department of Learning, Informatics, Management, and Ethics, Karolinska Institutet, and Faculty of Health and Life Sciences | Linnaeus University, Kalmar, Sweden (Dr Ekstedt).
Background:
Patients with lung cancer often undergo surgery shortly after diagnosis. Despite undergoing extensive operation, many patients are transferred to a local hospital a few days after surgery. Transitions between different levels of care are risky due to common medication and follow-up errors.
Objective:
The study purpose was to explore patients' experiences of transfer between hospitals after lung cancer surgery. The study aim was to improve the quality of transitional care.
Methods:
In-depth interviews with 14 patients with lung cancer (6 men, 8 women) were conducted in the patients' homes. Interviews were audiotaped, transcribed, and analyzed using the hermeneutic analysis method.
Results:
Patients' experience of transfer between hospitals after lung cancer surgery is one of being in a caregiver gap characterized by feeling unprepared and uncertain, feeling unprotected and not being cared for, and suffering because of inadequate organization. Patients are vulnerable and at risk of injury before and during transfer, as well as after arrival at local hospitals.
Conclusions:
Study findings highlight a rarely considered risk of inadequate care before, during, and after hospital transfer of vulnerable patients. Transition between hospitals after lung cancer surgery is a part of patient care for which there are no policies or care plans and a time during which the borders of responsibility between caregivers are unclear.
Implications For Practice:
It is important to develop guidelines for clearly defined responsibilities during transfer between hospitals. Healthcare providers need to plan transfers with the same rigor as they do hospital care.
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