Are patients discharged with care? A qualitative study of perceptions and experiences of patients, family members and care providers
Hesselink, Gijs (Radboud University Medical Centre. Scientific Institute for Quality of Healthcare)
Flink, Maria (Department of Social Work. Karolinska University Hospital)
Olsson, Mariann (Department of Social Work. Karolinska University Hospital)
Barach, Paul (School of Medicine. University College Cork)
Dudzik-Urbaniak, Ewa (National Center for Quality Assessment in Health Care)
Orrego, Carola (Universitat Autònoma de Barcelona. Institut Universitari Avedis Donabedian)
Toccafondi, Giulio (Clinical Risk Management and Patient Safety Centre. GRC)
Kalkman, Cor (Patient Safety Center. University Medical Center Utrecht)
Johnson, Julie K. (Centre for Clinical Governance Research in Health. University of New South Wales)
Schoonhoven, Lisette (Faculty of Health Sciences. University of Southampton)
Vernooij-Dassen, Myrra (Radboud University Medical Centre. Scientific Institute for Quality of Healthcare)
Wollersheim, Hub (Radboud University Medical Centre. Scientific Institute for Quality of Healthcare)

Date:	2012
Abstract:	Background: Advocates for quality and safety have called for healthcare that is patient-centred and decision-making that involves patients. Objective: The aim of the paper is to explore the barriers and facilitators to patient-centred care in the hospital discharge process. Methods: A qualitative study using purposive sampling of 192 individual interviews and 26 focus group interviews was conducted in five European Union countries with patients and/or family members, hospital physicians and nurses, and community general practitioners and nurses. A modified Grounded Theory approach was used to analyse the data. Results: The barriers and facilitators were classified into 15 categories from which four themes emerged: (1) healthcare providers do not sufficiently prioritise discharge consultations with patients and family members due to time restraints and competing care obligations; (2) discharge communication varied from instructing patients and family members to shared decision-making; (3) patients often feel unprepared for discharge, and postdischarge care is not tailored to individual patient needs and preferences; and (4) pressure on available hospital beds and community resources affect the discharge process. Conclusions: Our findings suggest that involvement of patients and families in the preparations for discharge is determined by the extent towhich care providers arewilling and able to accommodate patients' and families' capabilities, needs and preferences. Future interventions should be directed at healthcare providers' attitudes and their organisation's leadership, with afocus on improving communication among care providers, patients and families, and between hospital and community care providers.
Grants:	European Commission 223409
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Adult ; Chronic Disease ; Cross-Cultural Comparison ; Decision Making ; Efficiency, Organizational ; European Union ; Family ; Focus Groups ; Health Knowledge, Attitudes, Practice ; Health Personnel ; Health Services Needs and Demand ; Humans ; Interviews as Topic ; Patient Discharge ; Patient Handoff ; Patient-Centered Care ; Patients ; Qualitative Research
Published in:	BMJ Quality and Safety, Vol. 21 Núm. SUPPL. 1 (december 2012) , ISSN 2044-5415

DOI: 10.1136/bmjqs-2012-001165

11 p, 243.1 KB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Avedis Donabedian Research Institute-UAB
Articles > Research articles
Articles > Published articles