ArticleBMC health services research2017
"It's a waiting game" a qualitative study of the experience of carers of patients who require an alternate level of care.
Article in BMC health services research, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
27 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Transitional care programs for older adults moving from hospital to home in Canada: A systematic review of text and opinion.PloS one · 2024Pooled it
- Stakeholder perspectives of care for people living with dementia moving from hospital to care facilities in the community: a systematic review.BMC geriatrics · 2019Pooled it
- An Environmental Scan of Alternate Level of Care (ALC) Policies in Ontario, Canada.Canadian geriatrics journal : CGJ · 2026Article
- Delayed discharges in older adults with mental illness and/or dementia in hospital: a scoping review.BMC health services research · 2026Article
- Technology and Inpatient Care: Addressing Communication Barriers and Social Isolation.Journal of patient experience · 2026Article
- Article
- Predicting onward care needs at admission to reduce discharge delay using explainable machine learning.Scientific reports · 2025Article
- "Doing extra work and not getting extra help": the burden of work generated to manage the "no visitors" policy during the COVID-19 pandemic in Ontario, Canada.Frontiers in public health · 2025Article
- Effectiveness of the Sub-Acute Care for Frail Elderly (SAFE) Transitional Care Unit on Short-Term Functional Independence in Frail Older Patients Discharged from Hospital.Canadian geriatrics journal : CGJ · 2024Article
- Alternate Level of Care Patients in Canada: a Scoping Review.Canadian geriatrics journal : CGJ · 2024Article
- Factors Associated with Alternate Level of Care Status Designation: a Case-Control Study and Model to Optimize Care Trajectories.Canadian geriatrics journal : CGJ · 2024Article
- NegotiAge: Development and pilot testing of an artificial intelligence-based family caregiver negotiation program.Journal of the American Geriatrics Society · 2024Article
- 'Safety is about partnership': Safety through the lens of patients and caregivers.Health expectations : an international journal of public participation in health care and health policy · 2024Article
- Healthcare-Associated Adverse Events in Alternate Level of Care Patients Awaiting Long-Term Care in Hospital.Geriatrics (Basel, Switzerland) · 2022Article
- Variation in revascularisation use and outcomes of patients in hospital with acute myocardial infarction across six high income countries: cross sectional cohort study.BMJ (Clinical research ed.) · 2022Article
- Growing pains: Lessons learned from a failed mobile mindfulness clinical trial for patients with complex care needs.Contemporary clinical trials communications · 2022Article
- Multi-Disciplinary Discharge Coordination Team to Overcome Discharge Barriers and Address the Risk of Delayed Discharges.Risk management and healthcare policy · 2022Article
- Putting the Patient First: A Scoping Review of Patient Desires in Canada.Healthcare policy = Politiques de sante · 2021Article
- Understanding transitional care programs for older adults who experience delayed discharge: a scoping review.BMC geriatrics · 2021Article
- Article
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDelayed hospital discharge (also known as Alternate Level of Care or ALC) is a global health care quality issue with negative implications for people (e.g., functional decline) and the health care system (e.g., costly interruptions in hospital flow and procedures). ALC disproportionately impacts people with cognitive impairment, and insight into the needs and experiences of this specific sub population and their carers is lacking. The purpose of this study was to understand the hospital experience of carers (e.g., family members) of patients with ALC and cognitive impairment who were waiting for long-term care from the hospital.
methodsThis is a qualitative descriptive study entailing 12 semi-structured interviews with 15 carers of patients with ALC from three hospitals in Northwestern Ontario. Interviews were conducted between October 2015 and February 2016. Two reviewers thematically analyzed the interview data.
resultsFive core themes were identified from the interview data: patient over person, uncertain and confusing process, inconsistent quality in care delivery, carers addressing gaps in the system, and personalization of long-term care.
conclusionsWaiting for long-term care from the hospital is a stressful and uncertain time for family carers. ALC is an 'in-between' phase when patients and carers may be at their most vulnerable yet receive the least care from the formal care system. Carers provide critical insight into the needs and behaviors of patients as well as processes that need to be improved to enhance their experience. Such insights will help health systems internationally as they grapple with the issue of ALC whilst trying to optimize engagement with patients and their families.
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