Components of a proper hospital discharge for elders

Bull, Margaret J.; Roberts, Julia

doi:10.1046/j.1365-2648.2001.01873.x

Cited by 133 publications

(214 citation statements)

References 24 publications

(30 reference statements)

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“…Communication between hospital staff, patients and their families on discharge planning has been reported to be inadequate, (35) and some of this inadequacy is caused by the lack of engagement with patients and families during the discharge process. Therefore, early engagement with patients and families holds promise for facilitating smoother transfer between institutions.…”

Section: Discussionmentioning

confidence: 99%

Factors associated with prolonged length of stay in older patients

Toh

Lim

Yap

et al. 2017

smedj

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Section: Discussionmentioning

confidence: 99%

Factors associated with prolonged length of stay in older patients

Toh

Lim

Yap

et al. 2017

smedj

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“…Research often describes MDTs as comprising a core team including the named doctor and nurse, occupational therapists (OTs) and physiotherapists (PTs), and representatives from community and social care agencies, as well as family representatives, GPs and other specialist therapists. According to Bull and Roberts, 52 MDTs help break down barriers between professional groups and foster a sense of common purpose and trust. Importantly, MDTs provide an opportunity for communication, first between professionals, second with patient and family, and third with community health-care providers.…”

Section: Understanding Hospital Dischargementioning

confidence: 99%

“…61 In particular, co-ordinators acquire both deeper understanding of and extended relationships with a wider range of care agencies that help them better navigate and align divergent ways of working that usually delay or undermine discharge. 52,61,62 Integrating care services…”

Section: Hospital Discharge and Patient Safety: Reviews Of The Literamentioning

confidence: 99%

An ethnographic study of knowledge sharing across the boundaries between care processes, services and organisations: the contributions to ‘safe’ hospital discharge

Waring

Marshall

Bishop

et al. 2014

Health Services and Delivery Research

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BackgroundHospital discharge is a vulnerable stage in the patient pathway. Research highlights communication failures and the problems of co-ordination as resulting in delayed, poorly timed and unsafe discharges. The complexity of hospital discharge exemplifies the threats to patient safety found ‘between’ care processes and organisations. In developing this perspective, safe discharge is seen as relying upon enhanced knowledge sharing and collaboration between stakeholders, which can mitigate system complexity and promote safety.AimTo identify interventions and practices that support knowledge sharing and collaboration in the processes of discharge planning and care transition.SettingThe study was undertaken between 2011 and 2013 in two English health-care systems, each comprising an acute health-care provider, community and primary care providers, local authority social services and social care agencies. The study sites were selected to reflect known variations in local population demographics as well as in the size and composition of the care systems. The study compared the experiences of stroke and hip fracture patients as exemplars of acute care with complex discharge pathways.DesignThe study involved in-depth ethnographic research in the two sites. This combined (a) over 180 hours of observations of discharge processes and knowledge-sharing activities in various care settings; (b) focused ‘patient tracking’ to trace and understand discharge activities across the entire patient journey; and (c) qualitative interviews with 169 individuals working in health, social and voluntary care sectors.FindingsThe study reinforces the view of hospital discharge as a complex system involving dynamic and multidirectional patterns of knowledge sharing between multiple groups. The study shows that discharge planning and care transitions develop through a series of linked ‘situations’ or opportunities for knowledge sharing. It also shows variations in these situations, in terms of the range of actors, forms of knowledge shared, and media and resources used, and the wider culture and organisation of discharge. The study also describes the threats to patient safety associated with hospital discharge, as perceived by participants and stakeholders. These related to falls, medicines, infection, clinical procedures, equipment, timing and scheduling of discharge, and communication. Each of these identified risks are analysed and explained with reference to the observed patterns of knowledge sharing to elaborate how variations in knowledge sharing can hinder or promote safe discharge.ConclusionsThe study supports the view of hospital discharge as a complex system involving tightly coupled and interdependent patterns of interaction between multiple health and social care agencies. Knowledge sharing can help to mitigate system complexity through supporting collaboration and co-ordination. The study suggests four areas of change that might enhance knowledge sharing, reduce system complexity and promote safety. First, knowledge brokers in the form of discharge co-ordinators can facilitate knowledge sharing and co-ordination; second, colocation and functional proximity of stakeholders can support knowledge sharing and mutual appreciation and alignment of divergent practices; third, local cultures should prioritise and value collaboration; and finally, organisational resources, procedures and leadership should be aligned to fostering knowledge sharing and collaborative working. These learning points provide insight for future interventions to enhance discharge planning and care transition. Future research might consider the implementation of interviews to mediate system complexity through fostering enhanced knowledge sharing across occupational and organisational boundaries. Research might also consider in more detail the underlying complexity of both health and social care systems and how opportunities for knowledge sharing might be engendered to promote patient safety in other areas.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

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“…Subjects who report greater coordination of the discharge process will have higher RHDS scores that subjects who report poorer coordination (Bull & Roberts, 2001;Tierney et al, 1993).…”

mentioning

confidence: 97%

Psychometric Properties of the Readiness for Hospital Discharge Scale

Weiss

Piacentine²

2006

J Nurs Meas

180

313

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Abstract:The purpose of the study was to assess the psychometrics properties of the (Korttila, 1991) and continue their recovery at home or in an intermediate care facility. The need to assess readiness for hospital discharge and transition to another location and level of care has become increasingly important to patient safety, satisfaction, and outcomes. The purpose of this study was to evaluate the psychometric properties of the Readiness for Hospital Discharge Scale (RHDS), an instrument developed to measure patients' perception of their readiness for hospital discharge.

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Components of a proper hospital discharge for elders

Abstract: The findings provide insights for educating nurses about effective planning practices and examining the global significance of impediments to a proper hospital discharge.

Cited by 133 publications

References 24 publications

Factors associated with prolonged length of stay in older patients

Factors associated with prolonged length of stay in older patients

An ethnographic study of knowledge sharing across the boundaries between care processes, services and organisations: the contributions to ‘safe’ hospital discharge

Psychometric Properties of the Readiness for Hospital Discharge Scale

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