Navigating Rural Care Transitions: A Qualitative Study of Nursing Leaders’ Unit-Focused Approaches

Abstract

Background: Leadership is vital for well-coordinated healthcare and affects the quality of care and patient safety. Nursing leaders are crucial in creating appropriate structures and processes to enhance patient outcomes during care transitions in a rural context. Despite their importance to care transitions, there is limited research on nursing leaders’ perspectives in rural settings. This study explored nursing leaders’ concerns regarding the provision of quality care during transitions from hospital care to home healthcare in rural areas and their experiences in improving these processes.

Methods: A qualitative study using constructivist grounded theory methodology was conducted. Twenty nursing leaders in hospital and rural municipal care in Sweden were interviewed. All were educated in social care or healthcare, most in nursing, and most had a master’s degree. Data were analyzed using constant comparative analysis.

Results: Nursing leaders’ main concern about creating quality care in transitions was a lack of clearly defined, shared goals for a high-quality care transition. The core category explaining their approach was minding one’s unit by working within organizational unit borders. Three categories further explained this: (I) promoting nursing competence by recruiting and training nurses, emphasizing patient involvement, (II) ensuring continuous care flow by collaborating within one’s organization and clarifying rights and obligations, and (III) evaluating collaboration within each unit.

Conclusions: Seamless care transitions are challenging when nursing leaders lack clear, mutually shared quality goals for care transitions. Implications for nursing management include improving collaborative routines, establishing common platforms, and integrating patient input throughout the process, as these measures are essential for enhancing interorganizational collaboration in rural care transitions.