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Defining ready for discharge from sub-acute care: a qualitative exploration from multiple stakeholder perspectives
journal contribution
posted on 2023-05-26, 03:03 authored by Kate Gledhill, Tracey BucknallTracey Bucknall, Natasha A Lannin, Lisa HannaLisa HannaAbstract
Background
Planning discharges from subacute care facilities is becoming increasingly complex due to an ageing population and a high demand on services. The use of non-standardised assessments to determine a patient’s readiness for discharge places a heavy reliance on a clinician’s judgement which can be influenced by system pressures, past experiences and team dynamics. The current literature focusses heavily on discharge-readiness from clinicians’ perspectives and in the acute care setting. This paper aimed to explore the perceptions of discharge-readiness from the perspectives of key stakeholders in subacute care: inpatients, family members, clinicians and managers.
Methods
A qualitative descriptive study was conducted, exploring the views of inpatients (n = 16), family members (n = 16), clinicians (n = 17) and managers (n = 12). Participants with cognitive deficits and those who did not speak English were excluded from this study. Semi-structured interviews and focus groups were conducted and audio-recorded. Following transcription, inductive thematic analysis was completed.
Results
Participants identified that there are both patient-related and environmental factors that influence discharge-readiness. Patient-related factors discussed included continence, functional mobility, cognition, pain and medication management skills. Environmental factors centred around the discharge (home) environment, and were suggested to include a safe physical environment alongside a robust social environment which was suggested to assist to fill any gaps in functional capabilities (i.e. patient-related factors).
Conclusions
These findings make a unique contribution to the literature by providing a thorough exploration of determining discharge-readiness as a combined narrative from the perspectives from key stakeholders. Findings from this qualitative study identified key personal and environmental factors influencing patients’ discharge-readiness, which may allow health services to streamline the determination of discharge-readiness from subacute care. Understanding how these factors might be assessed within a discharge pathway warrants further attention.
History
Journal
BMC HEALTH SERVICES RESEARCHVolume
23Article number
ARTN 425Location
EnglandPublisher DOI
ISSN
1472-6963eISSN
1472-6963Language
EnglishIssue
1Publisher
BMCUsage metrics
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Keywords
Science & TechnologyLife Sciences & BiomedicineHealth Care Sciences & ServicesClinical decision-makingPatient readmissionLength of stayPatient dischargeQualitativeSub-acute CareEXPERIENCESREADINESSHumansPatient DischargeSubacute CareQualitative ResearchFocus GroupsInpatientsBehavioral and Social ScienceClinical ResearchPain Research8 Health and social care services research8.1 Organisation and delivery of services3 Good Health and Well BeingLibrary and Information StudiesPublic Health and Health Services not elsewhere classifiedNursing not elsewhere classified
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