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Table 1 Examples of intervention components for each of the three important aspect of transitional safety voiced by the TIPP participants

From: Improving transitional patient safety: research protocol of the Transitional Incident Prevention Programme

Health care process Transitional patient safety culture Patient empowerment
Transitional incident reporting committee: Providing a neutral place for feedback of incidents, will provide insight in system errors in transitional patient safety and fosters improvement of the healthcare process. Also, it improves transitional patient safety culture by stimulating feedback between GP and hospital and exchanging news. Patient info card: providing information to patients to address major safety items in transitional care using cartoons and short easy understandable language
Safe email communication: providing a place to communicate short messages about specific patients. This does not replace the extensive communication (e.g. discharge letters), but offers a place to communicate important (but not urgent) messages about medical policy requests (e.g. control lab tests a week after discharge) or changes (e.g. medication changes after outpatient visit) Transitional patient safety culture workshop: Introducing GP’s and hospital professionals and providing information about transitional risks and safety, to create a shared vision on communication, collaboration and responsibility in transitional care. Introducing the professionals to each other will lower the threshold to communicate and provide feedback on specific patients. Medication passports: providing patients with (empty) medication passports before the first outpatient appointment. A patient will be requested to fill in the passport according to the medication they use at that moment. There is also room for their medical background and allergies.
A prospective risk analysis (PRA) or Healthcare Failure Mode and Effect Analysis (HFMEA) of a regional problem in transitional care. E.g. an HFMEA on discharge of patients from the outpatient clinic to the GPs or hospital diagnostics requested by the GP (like gastroscopy or cardiac stress test) [26, 27]. Regular (half-yearly) informal gatherings between professionals from GP and hospital: personal acquaintance between professionals from GP and hospital will lower the threshold to communicate and provide feedback on specific patients. A patient health app: providing a patient with a digital medication passport on their smartphone or tab to register their medication, medical background, and allergies and update the medication regularly (after every adjustment).
  1. GP = general practitioner