Cathrine Buaas Tverdal, Emilie Isager Howe, Cecilie Røe, Eirik Helseth, Juan Lu, Olli Tenovuo, Nada Andelic
Department of Physical Medicine and Rehabilitation, Department of Neurosurgery, Oslo University Hospital, 0424 Oslo, Norway. E-mail: cathrinebt@gmail.com
DOI: 10.2340/16501977-2332

Objectives: To describe the discharge process for patients with traumatic brain injury from a trauma hospital, and patient experience and satisfaction with care transition. Furthermore, to evaluate associations between discharge process and patient satisfaction and quality of care transition.
Design: Prospective-retrospective observational study.
Subjects/patients: Seventy-four patients admitted to ward or intensive care unit at a trauma referral hospital within 24 h of traumatic brain injury.
Methods: Baseline characteristics and discharge process variables were extracted from medical records. Patients were interviewed 6-months post-injury about their experience and satisfaction with care transition, using a visual analogue scale (VAS) and the Care Transition Measurement (CTM-3®) as outcome measures. Regression analyses were performed to investigate associations between discharge process and outcome.
Results: One-third of patients were not involved in the discharge process, and information in discharge summaries was often inadequate. Patients’ involvement in care transition and co-ordination of care were significantly associated with overall satisfaction (VAS, p = 0. 002 and p = 0. 001, respectively) and quality of care transition (CTM-3®, p = 0. 003 and p = 0. 007, respectively). Patients with more severe injuries reported lower satisfaction and quality of care transition.
Conclusion: Patient’s involvement in healthcare decision-making and co-ordination of care is important for self-reported satisfaction with transition and quality of care transition.

Discharge from a trauma hospital represents an important event, because that is when plans are made regarding further need for follow-up and healthcare services. However, we do not have sufficient information about how discharge is planned for people who have had a traumatic brain injury (TBI), how the patients perceive this process, or how satisfied they are with it. This study investigated to what degree the discharge was planned, by reviewing information in the medical records and by asking the patients about their experience and satisfaction with the discharge process. It was found that the degree to which the discharge was planned varied, and the main factors affecting how the patients perceived the quality of the discharge process and how they rated it, was the experience of being involved in the discharge process and how well-coordinated it was. Patients with more severe overall injury were less satisfied with discharge and its quality, suggesting that special consideration should be given to patients with more severe injuries.