Systematic review of contemporary improvement interventions on care coordination, discharge support and transitional care from the patient experience perspective

Aim: To synthesize the impact of improvement interventions related to care coordination and discharge support on patient experience measures. Method: Systematic review. Searches were completed in six scientific databases, five specialty journals and through snowballing. Eligibility included studies in English (2015-2022) on improving care coordination, discharge support, or transitional care assessed by standardized patient experience measures as a primary outcome. Two independent reviewers made eligibility decisions and performed quality appraisals. Results: Of 1087 papers initially screened, 15 were finally included. Seven studies (three randomized controlled trials [RCTs]) focused on care coordination activities and used enhanced supports (e.g., improvement coaching; tailoring for vulnerable populations) for Patient-Centered Medical Homes or other primary care sites. Effectiveness was mixed or neutral relative to standard supports or models of care. Eight studies (three RCTs) focused on enhanced discharge support, including patient education (e.g., “teach back” method) and telephone follow-up or transitional support; mixed or neutral results on the patient experience were also found and with more substantive risks of bias. Conclusion: Enhanced supports for improving care coordination, discharge education, and post-discharge follow-up had mixed or neutral effectiveness for improving the patient experience with care, compared to standard or simpler improvement approaches. Studies on the improvement of patient experiences, especially for enhanced patient discharge, need further strengthening such as including the patient perspective for its co-development. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement Yes ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Not applicable: systematic review. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes The data are provided as supplementary materials.