Coordination of care in hospitals: A rapid review of the literature

Abstract

PProject SWIFT (System Wide Integration for Transformation) is a programme of work supported by developments in technology, that aims to improve the health of people in Counties Manukau through initiatives focused on community-based care and improving hospital systems. A “rapid review” of literature focussing on coordination of care in hospitals was carried out to support this project. Rapid review is a literature review methodology that is “streamlined” by limiting: the number of databases searched, the types of study design included, the languages that articles are written in, the dates when articles were written, and the level of inclusion of “grey” literature. In total, 30 articles were considered in detail for inclusion in this rapid review, with many other articles considered briefly from title or abstract alone. Of the 30 articles, 12 (40%) were ultimately deemed relevant, and included. In total, 112 unique articles contributed to the literature review, if all of the articles considered by three systematic reviews that contributed to this rapid review are included. The review found reasonable evidence that implementation of patient care delivery models focussing on coordination of care and efficiency can contribute to reductions in length of stay for hospital patients. In addition, reasonable evidence was found indicating that that the use of preoperative briefings and surgical safety checklists by operating teams can improve patient safety outcomes. However, it was not possible to draw firm conclusions from many of the other articles that were reviewed: these tended not to describe measurable improvements to patient outcomes or efficiency, and instead focussed on results that were process rather than outcome oriented, subjective, reported improvements that were not compared against any other measure, or were non-significant.