Systemic contradictions as causes to challenges in nurses' transitional care: A change laboratory intervention

Area of Science:

• Healthcare Management
• Nursing Practice
• Patient Care Coordination

Background:

• Transitional care coordination between primary and hospital settings is complex.
• Collaboration challenges arise from differing goals among patients, professionals, and organizations.
• Fragmented care pathways can negatively impact patient outcomes.

Purpose of the Study:

• To explore how identified developmental needs can enhance transitional care.
• To understand participants' perspectives on improving care transitions for patients.
• To investigate the impact of a learning intervention on nurses' approach to transitional care.

Main Methods:

• Formative intervention design based on Cultural Historical Activity Theory.
• Utilized the change laboratory method and double stimulation principle.
• Employed a mixed-methods approach with quantitative and qualitative analysis.

Main Results:

• Participants highlighted the need for greater patient and family involvement and emphasized relational care.
• Nurses gained insight into collaboration challenges and the formation of nursing practice.
• Identified systemic contradictions between bureaucratic demands and patient expectations for coherent care.

Conclusions:

• Understanding challenges shifted focus from surface problems to underlying systemic contradictions.
• This approach offers a potential alternative to superficial problem-solving in healthcare.
• Addressing systemic issues may lead to long-term improvements in transitional care practices.