Complex medical therapies such as outpatient parenteral antimicrobial therapy (OPAT), typically performed in acute care hospital, are moving to the home setting, requiring patients and informal caregivers to perform complicated medical tasks. This study sought to describe patient, caregiver, and health care worker’s understanding of their roles in OPAT and barriers to fulfilling these roles. Role ambiguity was a consistent finding in all three groups highlighting the need for enhanced training for people performing these tasks.

Patients are at risk for adverse events after they transition from hospital to home. This direct observation and interview study identified significant concerns related to care transitions from hospital to home health care among patients discharged from the hospital. The study team found instances of missing and erroneous information. Information also had to be gleaned from multiple sources, and too much information could cause confusion and interfere with home health care. The authors recommend redesigning the care transition process from hospital to home health care providers in order to promote safety.

Patient transfers are vulnerable to missteps that can adversely affect patient care. This commentary draws from core elements of four care transitions improvement models for older patients to suggest an innovative approach that focuses on communication between providers, goals-of-care discussions, coordination of care plans, medication reconciliation, high-quality discharge summaries, and patient-centered instructions.

Patients are at risk for adverse events after they transition from hospital to home. This study used review of malpractice claims and stakeholder focus groups to inform planning tools for postdischarge care transitions. Pilot testing of the tools demonstrated acceptability and feasibility for patients and providers. These results suggest that malpractice data can inform safety improvement approaches.