# Legislative compliance in coordinated care transitions: a mixed-method study of healthcare professionals' documentation and older adults' experiences

## TL;DR

This study examines how well care transitions for older adults align with legal standards, finding gaps in documentation and patient involvement.

## Contribution

The study reveals inconsistencies between documented procedures and actual patient inclusion in care transitions.

## Key findings

- Individual care plans were often missing or poorly documented.
- Older adults were frequently excluded from decision-making despite some cases of genuine participation.
- Standardized and inclusive documentation practices are urgently needed.

## Abstract

This study aimed to explore and describe how coordinated care transitions aligned with legislation when older adults are discharged from in-patient care to their homes.

A mixed-method (QUAL + qual) design was used. The core data component (QUAL) consisted of copies of 15 older adults' healthcare and social care records. The supplementary data component (qual) encompassed individual interviews. All data related to the same older adults, whose coordinated care transitions took place between January to June 2022. The analytical procedure followed a deductive thematic analysis.

Findings showed that individual care plans were often missing or inadequately documented. Documentation of older adults' participation was frequently poor and inconsistent, with many decisions made without their input. However, some documents and interviews indicated that older adults had genuinely participated. The discrepancy between documented procedures and actual experiences reveals significant variability in older adults' inclusion.

This study highlights the frequent exclusion of older adults from coordinated care transition process and deficiencies in documentation. The findings underscore the urgent need for standardized and inclusive documentation practices, as well as improved communication strategies, to ensure more person-centred care transitions, in which older adults are genuinely involved and well-informed about their care transitions.