An exploratory study of discharge planning home visits within an Irish context – investigating nationwide practice and nationwide perspectives

Abstract

Purpose Discharge planning home visits (DPHVs) are a routine part of occupational therapy clinical practice. However, there is a dearth of evidence to support or refute their efficacy and limited policies or standards to guide clinical practice. This study aims to investigate current clinical practice during home visits and the value that occupational therapists’ attribute to home visits within an Irish context. Design/methodology/approach Data collection was carried out by using a survey questionnaire (postal and electronic options). The study population comprised occupational therapists across 52 sites including acute, rehabilitation and convalescence settings within the Republic of Ireland. In total, 122 occupational therapists that completed the survey questionnaire were recruited for the study. Findings Quantitative data identified time spent per visit, departmental size, hospital size, number of visits and report writing times. Information was gathered regarding clinical areas assessed during visits in a Likert scale format. Qualitative data identified benefits, risks, recommendations to improve home visit practice and clinical criteria for home visits. Findings conclude that DPHVs are routinely carried out by occupational therapists and that there is consistency in clinical practice within an Irish setting. Occupational therapists value home visits as clinical assessments and have identified risks during practice, benefits of visits and ways to improve practice. Originality/value This study has provided a reflection of clinical practice in the Republic of Ireland. It is the only study of its kind in an Irish setting, and it could be used as a knowledge base regarding current practice on DPHV and occupational therapists’ clinical reasoning regarding home visits. The information gathered in this study could influence policies regarding DPHV and could serve as a comparison to standardise practice and justify the need for DPHV.

Effects, barriers and facilitators in predischarge home assessments to improve the transition of care from the inpatient care to home in adult patients: An integrative review

“…Intervention planning and evaluation. Novice therapists in particular struggled with the aim and content of PDHA [40]. The actual timing of PDHA was highly dependent on organizational factors and resource availability [34,35,39].…”

“…Eleven qualitative studies with a total of 346 participants (range: n=4 [36] to n=122 [40]) were included. All the studies used interview techniques, one used participant observation additionally [37], and another one used a semistructured survey [40].…”

“…Eleven qualitative studies with a total of 346 participants (range: n=4 [36] to n=122 [40]) were included. All the studies used interview techniques, one used participant observation additionally [37], and another one used a semistructured survey [40]. Three studies explored perceptions of patients, therapists and older adults in community dwellings with regard to the use of virtual reality (VR) applications in PDHA [10,33,34].…”

“…Three studies explored perceptions of patients, therapists and older adults in community dwellings with regard to the use of virtual reality (VR) applications in PDHA [10,33,34]. Three studies explored factors considered by OTs when deciding about stroke patients' need for a predischarge home assessment visit, as well as clinical reasoning and practice of PDHA [34,[38][39][40]. One study focused on older adults' and carers' perception of and involvement in PDHA decision-making processes [32].…”

“…Participants highlighted the importance of safety after hospital discharge [40]. The aim was to identify any required provisions and adaptations before going home and to identify and eliminate risks within the home [3,32,34,40], as well as to assess whether the home environment was suitable for the required equipment [34]. The facilitators were the structured identi cation of risk factors and patient/family's awareness of these factors following education, therefore enabling practical recommendations [40].…”