Defining ready for discharge from sub-acute care: a qualitative exploration from multiple stakeholder perspectives
Abstract 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 judgemen...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-05-01
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| Series: | BMC Health Services Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12913-023-09285-y |
| _version_ | 1797832180383088640 |
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| author | Kate Gledhill Tracey K Bucknall Natasha A Lannin Lisa Hanna |
| author_facet | Kate Gledhill Tracey K Bucknall Natasha A Lannin Lisa Hanna |
| author_sort | Kate Gledhill |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-04-09T14:03:40Z |
| format | Article |
| id | doaj.art-bb905192372441a1928513d6d87de6b2 |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-04-09T14:03:40Z |
| publishDate | 2023-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-bb905192372441a1928513d6d87de6b22023-05-07T11:09:35ZengBMCBMC Health Services Research1472-69632023-05-0123111110.1186/s12913-023-09285-yDefining ready for discharge from sub-acute care: a qualitative exploration from multiple stakeholder perspectivesKate Gledhill0Tracey K Bucknall1Natasha A Lannin2Lisa Hanna3School of Health and Social Development, Deakin UniversitySchool of Nursing and Midwifery, Deakin UniversityDepartment of Neuroscience, Central Clinical School, Monash UniversitySchool of Health and Social Development, Deakin UniversityAbstract 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.https://doi.org/10.1186/s12913-023-09285-yClinical decision-makingPatient readmissionLength of stayPatient dischargeQualitativeSub-acute Care |
| spellingShingle | Kate Gledhill Tracey K Bucknall Natasha A Lannin Lisa Hanna Defining ready for discharge from sub-acute care: a qualitative exploration from multiple stakeholder perspectives BMC Health Services Research Clinical decision-making Patient readmission Length of stay Patient discharge Qualitative Sub-acute Care |
| title | Defining ready for discharge from sub-acute care: a qualitative exploration from multiple stakeholder perspectives |
| title_full | Defining ready for discharge from sub-acute care: a qualitative exploration from multiple stakeholder perspectives |
| title_fullStr | Defining ready for discharge from sub-acute care: a qualitative exploration from multiple stakeholder perspectives |
| title_full_unstemmed | Defining ready for discharge from sub-acute care: a qualitative exploration from multiple stakeholder perspectives |
| title_short | Defining ready for discharge from sub-acute care: a qualitative exploration from multiple stakeholder perspectives |
| title_sort | defining ready for discharge from sub acute care a qualitative exploration from multiple stakeholder perspectives |
| topic | Clinical decision-making Patient readmission Length of stay Patient discharge Qualitative Sub-acute Care |
| url | https://doi.org/10.1186/s12913-023-09285-y |
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