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Understanding the patient experience of early unplanned hospital readmission following acute care discharge: a qualitative descriptive study

Considine, Julie-Anne, Berry, Debra, Sprogis, Stephanie K, Newnham, Evan, Fox, Karen, Darzins, Peteris, Rawson, Helen and Street, Maryann 2020, Understanding the patient experience of early unplanned hospital readmission following acute care discharge: a qualitative descriptive study, BMJ Open, vol. 10, no. 5, pp. 1-10, doi: 10.1136/bmjopen-2019-034728.

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Title Understanding the patient experience of early unplanned hospital readmission following acute care discharge: a qualitative descriptive study
Author(s) Considine, Julie-AnneORCID iD for Considine, Julie-Anne orcid.org/0000-0003-3801-2456
Berry, DebraORCID iD for Berry, Debra orcid.org/0000-0002-8780-054X
Sprogis, Stephanie KORCID iD for Sprogis, Stephanie K orcid.org/0000-0003-4259-6976
Newnham, Evan
Fox, Karen
Darzins, Peteris
Rawson, HelenORCID iD for Rawson, Helen orcid.org/0000-0001-5363-729X
Street, MaryannORCID iD for Street, Maryann orcid.org/0000-0002-5615-141X
Journal name BMJ Open
Volume number 10
Issue number 5
Article ID e034728
Start page 1
End page 10
Total pages 10
Publisher BMJ
Place of publication London, Eng.
Publication date 2020-05-20
ISSN 2044-6055
2044-6055
Keyword(s) health services administration & management
organisation of health services
qualitative research
Patient experience
Unplanned hospital readmission
Discharge planning
Summary Objectives To understand from a patient and carer perspective: (1) what features of the discharge process could be improved to avoid early unplanned hospital readmission (within 72 hours of acute care discharge) and (2) what elements of discharge planning could have enhanced the discharge experience. Design A qualitative descriptive design was used. Study data were collected using semi-structured interviews that were transcribed verbatim and analysed using inductive thematic analysis. Data related to participant characteristic were collected by medical record audit and summarised using descriptive statistics. Setting Three acute care hospitals from one health service in Australia. Participants Patients who had an early unplanned hospital readmission and/or their carers, if present during the interviews and willing to participate, with patient permission. Findings Thirty interviews were conducted (23 patients only; 6 patient and carer dyads; 1 carer only). Five themes were constructed: ‘experiences of care’, ‘hearing and being heard’, ‘what’s wrong with me’, ‘not just about me’ and ‘all about going home’. There was considerable variability in patients’ and carers’ experiences of hospital care, discharge processes and early unplanned hospital readmission. Features of the discharge process that could be improved to potentially avoid early unplanned hospital readmission were better communication, optimal clinical care including ensuring readiness for discharge and shared decision-making regarding discharge timing and goals on returning home. The discharge experience could have been enhanced by improved communication between patients (and carers) and the healthcare team, not rushing the discharge process and a more coordinated approach to patient transport home from hospital. Conclusions The study findings highlight the complexities of the discharge process and the importance of effective communication, shared decision-making and carer engagement in optimising hospital discharge and reducing early unplanned hospital readmissions.
Language eng
DOI 10.1136/bmjopen-2019-034728
Indigenous content off
Field of Research 111003 Clinical Nursing: Secondary (Acute Care)
1103 Clinical Sciences
1117 Public Health and Health Services
1199 Other Medical and Health Sciences
Socio Economic Objective 920210 Nursing
HERDC Research category C1 Refereed article in a scholarly journal
Free to Read? Yes
Persistent URL http://hdl.handle.net/10536/DRO/DU:30137503

Document type: Journal Article
Collections: Faculty of Health
School of Nursing and Midwifery
Open Access Collection
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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.