Engineering safer care coordination from hospital to home: lessons from the USA

The safe transition of a patient from hospital into the community requires effective coordination between healthcare professionals across organisational boundaries. Preventing transition-associated failures can be especially challenging when multiple disciplines are involved and the patient has extensive care needs. The field of systems engineering is increasingly recognised as useful to help understand, improve and redesign such complex healthcare processes to improve patient experience and outcomes. To illustrate this approach, we describe how a partnership between healthcare professionals, systems engineers, and health services researchers used a series of engineering methods at a large suburban hospital to analyse and address deficiencies in a hospital-to-home transition process. Using this approach, the team designed a new process to perform more reliably despite inherent system complexity, demonstrating the value of systems engineering approaches and clinician-engineer collaborations.