Transitional Care Literature Review

n Malaysia, 2 465 727 patients were admitted to the hospital in 2015. Most of this patient will experiencing transition to primary care after they were discharge from the hospital. Previous studies had been showed that poor transitional care might cause harm to the patient especially for those who are vulnerable such as elderly or people who have special needs. Position statement issued by the American Geriatrics Society in 2003 described transitional care as a set of action designed to ensure the coordination and continuity of health care as patient transfer between different level of care. His study also suggested that many patients did not receive optimal transitional care due to urgent and unplanned transition especially due to high loads

This study has never been explored in Malaysia therefore it is important to assess patient’s perception regarding quality of our current discharge transition not only to improve our current system but also to develop intervention later. Assessment of patient’s perception will be done by using Care Transitional Measure (CTM-15) ® which include four domains; information transfer, patient and caregiver preparation, support for self-management and empowerment to assert preferences. CTM 15® have been validated by many countries and available in multi languages. CTM-15® had been shown ability to assess CHAPTER 2 LITERATURE REVIEW 2.1 Transitional care Transitional care had been defined as a set of action to maintain optimal quality of care upon transition between different level of healthcare. Furthermore, World Health Organization has recognized that error in transitional care as preventable morbidity. Previous study also showed that good transitional care is very important especially for vulnerable patient such as elderly and patients with special needs. These patients usually required complex care as they usually received treatment from different medical

Furthermore, lack of patient’s self-responsibility also unfavourable factors in discharge process. 2.3 Impact in poor discharge transition Medication error is the most common problem in poor transitional care. A study done by Foster et al found that almost one in five patients experienced an adverse event during the transition from the hospital to home which 72% of those adverse events are due to medication. During admission, most of the patient will experience medication changes such as new medication was added or pre-admission medication was withheld either temporarily during acute treatment or permanently. A study done found that almost all patient who was discharged from hospital have medication changed however only 12% was given clear written instruction to stop their pre-admission medication. Other studies have found that more than half of the patient who was discharged from hospital had at least one unintended medication discrepancy. Meanwhile, the most common error was omission of pre-admission medication which accounts about 46%. From this study, they also found that 61.4% of this error have no potential harm however 38.6% of this error have potential harm to the