Review of Human Factors Ergonomics in Hospital to Home Transitions of Care

The transition of patients from hospital to home was associated with increased patient morbidity and mortality due to the complexity of the health care system, patient factors, and poor communication and planning at discharge. Transitions of care were also associated with unplanned healthcare utilization. The Patient Protection and Affordable Care Act of 2010 regulated the formation of several payment model changes that incentivized health systems to deliver quality care instead of a large quantity of care. Transitions of care best practices were synthesized by reviewing published literature. The SEIPS model for patient safety was utilized to propose the redesign of a transition of care process based on synthesized best practices utilizing a risk assessment and PDSA change cycles.