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The Participant-Reported Implementation Update and Score PRIUS: A Novel Method for Capturing Implementation-Related Data Over Time
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Mixed Methods Study of the Interfacility Transfer System Utilizing Both Patient-Reported Experiences and Direct

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    Patient experiences with emergency department transfers reveal communication gaps and logistical challenges. Improving these aspects of interfacility transfers can enhance patient engagement and decision-making.

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    Area of Science:

    • Health Services Research
    • Patient Experience
    • Qualitative Research

    Background:

    • Interfacility transfer is a critical healthcare process lacking standardized patient engagement protocols.
    • Limited understanding exists regarding patient and care partner experiences during emergency department (ED)-to-ED transfers.

    Purpose of the Study:

    • To qualitatively explore the experiences of older adult patients and their care partners undergoing interfacility ED-to-ED transfer.
    • To identify key themes influencing patient and care partner perceptions of the transfer process.

    Main Methods:

    • Mixed methods approach combining bedside semistructured interviews with patients and care partners (n=35).
    • Direct observation of the transfer consent process in referring community EDs (n=14 encounters).

    Main Results:

    • Key themes included communication deficits (lack of agency), logistical issues (wait times), family impact (distance), financial uncertainty (costs), and perceived quality of care differences.
    • Observed variability in transfer consent practices and identified patient-reported issues like distractions, lack of privacy, and health literacy challenges.

    Conclusions:

    • Findings highlight opportunities to improve interfacility transfer care.
    • Enhancing patient and care partner engagement and shared decision-making is crucial for aligning care with patient goals.