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Table 3 Transitional care intervention characteristics (N = 17 studies)

From: Transitions of care interventions to improve quality of life among patients hospitalized with acute conditions: a systematic literature review

Intervention characteristics

Study citations

Number of studies

Type of facilitator

  

 Nurse(s)

[26, 27, 31,32,33,34,35,36,37,38,39,40, 42]

13

 Social worker(s)

[28]

1

 Interdisciplinary team

[29, 30, 41]

3

Training of facilitator

  

 Reported

[24,25,26, 31,32,33, 36, 38, 39]

7

 Not reported

[27,28,29,30, 34, 35, 37, 40,41,42]

10

Intervention materials

  

 Reported

[24, 32,33,34,35,36, 39,40,41]

8

 Not reported

[25,26,27,28,29,30,31, 37, 38, 42]

9

Intervention components

  

 Patient needs assessment

[24, 25, 28, 29, 31,32,33, 35, 38,39,40,41,42]

11

 Family needs assessment

[28, 39]

2

 Identification/involvement of family caregiver

[32, 33, 38, 42]

4

 Problem-solving

[24, 28, 31, 39]

3

 Phone calls

[24,25,26,27,28,29, 31,32,33,34, 37, 39, 41, 42]

12

 Hospital visits

[24,25,26, 37, 38]

3

 Clinic visits

[25, 29, 30, 41]

3

 Home visits

[24, 26, 28, 30, 33, 36, 38,39,40,41,42]

10

 Telehealth (i.e., video conferencing)

[35]

1

 Discharge planning/preparation

[24, 26, 32, 34]

3

 Patient education

[24,25,26, 28,29,30,31,32,33,34,35,36,37,38,39,40,41,42]

16

 Family education

[24, 26, 28, 31, 32, 37,38,39]

7

 Use of teach-back method

[24]

1

 Distribution of educational materials

[24, 34, 36, 39,40,41]

5

 Care coordination/patient navigation

[28, 29, 33, 41]

4

 Referral to other services

[24, 28, 29, 32, 37, 38, 40, 41]

7

 Development of nursing report

[24, 38]

1

 Development of individualized health plan

[24, 30,31,32, 34, 38, 40]

6

 Contact with primary care providers or other community providers

[25, 27, 29, 34, 38, 40,41,42]

7

 Encourage patient to contact PCP

[31, 39, 40]

3

 Motivational interviewing

[24, 32]

1

 On-call provider line

[24, 25, 29, 31, 32, 37, 41, 42]

6

 Monitoring patient progress

[25, 27, 28, 33, 35, 40]

5

 Interdisciplinary rehabilitation/physical training

[30, 33, 41]

3

 Goal setting

[31, 33]

2

 Regular data collection

[25, 27, 29, 35, 41]

4

 Distribution of medical records to patient

[42]

1

 Medication reconciliation

[29, 41]

2

 Medication management

[25, 29, 41]

2

 Interdisciplinary cooperation

[24, 25, 29, 30, 34, 41]

4

 Other

[27, 33, 35,36,37, 41, 42]

7

Cultural tailoring of intervention

 

0

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