RT Journal Article SR Electronic T1 Patient and caregiver priorities in the transition from hospital to home: results from province-wide group concept mapping JF BMJ Quality & Safety JO BMJ Qual Saf FD BMJ Publishing Group Ltd SP 390 OP 400 DO 10.1136/bmjqs-2019-009993 VO 29 IS 5 A1 Tara Kiran A1 David Wells A1 Karen Okrainec A1 Carol Kennedy A1 Kimberly Devotta A1 Gracia Mabaya A1 Lacey Phillips A1 Amy Lang A1 Patricia O'Campo YR 2020 UL http://qualitysafety.bmj.com/content/29/5/390.abstract AB Background Patients and caregivers often face significant challenges when they are discharged home from hospital. We sought to understand what influenced patient and caregiver experience in the transition from hospital to home and which of these aspects they prioritised for health system improvement.Methods We conducted group concept mapping over 11 months with patients—and their caregivers—who were admitted to a hospital overnight in the last 3 years in Ontario, Canada and discharged home. Home included supportive housing, shelters and long-term care. Participants responded to a single focal prompt about what affected their experience during the transition. We summarised responses in unique statements. We then recruited participants to rate each statement on a five-point scale on whether addressing this gap should be a priority for the health system. The provincial quality agency recruited participants in partnership with patient, community and healthcare organisations. Participation was online, in-person or virtual.Results 736 participants provided 2704 responses to the focal prompt. Unique concepts were summarised in 52 statements that were then rated by 271 participants. Participants rated the following three statements most highly as a gap that should be a priority for the health system to address (in rank order): ‘Not enough publicly funded home care services to meet the need’, ‘Home care support is not in place when arriving home from hospital’ and ‘Having to advocate to get enough home care’. The top priority was consistent across multiple subgroups.Conclusions In a country with universal health insurance, patients and caregivers from diverse backgrounds consistently prioritised insufficient public coverage for home care services as a gap the health system should address to improve the transition from hospital to home.