Evaluating Benefites and Disadvantages of Care Transition in Emergency Departments in Tehran

Field and clinical studies show that care transition after the relevant service is determined is one of the ways to deal with overcrowding in the emergency room. In addition, this method will reduce the workload of emergency physicians and even other personnel such as nurses and assistant nurses. However, some physicians believe that due to legal aspects, transition of patients’ care is not a suitable option. Because of the importance of this issue in managing the emergency rooms all over Iran and improving the quality of the services provided, and also, due to the lack of any study on the advantages and disadvantages of care transition, this research was conducted.

This qualitative content analysis study was conducted in 2020-2021 to investigate the advantages and disadvantages of patient care transition in emergency rooms in Tehran. 17 experts and medical managers at the Ministry of Health, university, and hospital levels and experts in emergency medicine were interviewed and asked to explain their opinions in this regard in a semi-structured interview. All the interviews were recorded with the permission of the participants and their text was transcribed verbatim and analyzed by the researchers using the content analysis method.

In the present study, 423 initial codes were extracted in the initial analysis, and after removing duplicate codes, the number of final codes reached 218. After reviewing and analyzing the data, advantages, and disadvantages were categorized into three main categories. Also, the benefits included 3 categories and 10 sub-categories. Patients’ status category (3 subcategories of patient care services, patient hoteling, medical errors), physicians’ status category (3 subcategories of physicians’ accountability, impact on the practical experience of physicians, physicians’ differences), and emergency department management category (occupancy of beds, emergency department income, educational opportunities for Emergency medicine, management of emergency medicine).

According to the studies and analyses performed, care transition has more disadvantages from the viewpoint of emergency medicine and affects the management and performance of the emergency department, the performance of physicians and residents, and the condition of patients. Considering the significant disadvantages of this process and the decrease in service quality and patient satisfaction, as well as the dissatisfaction of the treatment staff, the existing guidelines need to be revised.