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Understanding how to improve collaboration between hospitals and primary care in postdischarge care transitions: A qualitative study of primary care leaders' perspectives
Author(s) -
Nguyen Oanh Kieu,
Kruger Jenna,
Greysen S. Ryan,
Lyndon Audrey,
Goldman L. Elizabeth
Publication year - 2014
Publication title -
journal of hospital medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.128
H-Index - 65
eISSN - 1553-5606
pISSN - 1553-5592
DOI - 10.1002/jhm.2257
Subject(s) - medicine , incentive , primary care , interoperability , nursing , qualitative research , interpersonal communication , focus group , collaborative care , information sharing , family medicine , business , psychology , social psychology , social science , marketing , sociology , computer science , economics , microeconomics , operating system , political science , law
BACKGROUND There is limited collaboration between hospitals and primary care despite parallel efforts to improve postdischarge care transitions. OBJECTIVE To understand what primary care leaders perceived as barriers and facilitators to collaboration with hospitals. METHODS Qualitative study with in‐depth, semistructured interviews of 22 primary care leaders in 2012 from California safety‐net clinics. RESULTS Major barriers to collaboration included lack of institutional financial incentives for collaboration, competing priorities (e.g., regulatory requirements, strained clinic capacity, financial strain) and mismatched expectations about role and capacity of primary care to improve care transitions. Facilitators included relationship building through interpersonal networking and improving communication and information transfer via electronic health record (EHR) implementation. CONCLUSIONS Efforts to improve care transitions should focus on aligning financial incentives, standardizing regulations around EHR interoperability and data sharing, and enhancing opportunities for interpersonal networking. Journal of Hospital Medicine 2014;9:700–706. © 2014 Society of Hospital Medicine