Discharging older people from hospital to home: what do we know?

Abstract

Aims and objectives. The aim of this literature review was to examine empirical research to date on hospital discharge and illuminate areas in need of further exploration. Background. Discharging older people from hospital has long been associated with difficulties and complications. With a steady increase in the ageing population in Ireland and their use of acute hospital services, the successful management of hospital discharge is now a central concern to health service management. Methods. Using a seven-step approach by Stolz et al. [Scandinavian Journal of Caring Sciences (2004) Vol. 18, 111-119] a keyword database search was conducted which revealed 44 studies that matched the author's inclusion criteria. Results. These studies uncover aspects of the discharge process that are in need of further research, and particularly suggest more rigour in the measurement of hospital discharge outcomes. Relevance to clinical practice. This review focuses on a very important clinical issue given the predicted increase in the use of acute services by older people and the known vulnerabilities of the interface between hospital and community settings.

Quality care outcomes following transitional care interventions for older people from hospital to home: a systematic review

“…Some reviewers nominated re-hospitalization rates as an outcome capturing risk and safety following transitional care [27, 30, 34]. Effective communication between health providers during care transitions of older people has also been identified as important in reducing risks and adverse outcomes [11, 27, 34, 35]. …”

“…Numerous reviewers have identified limited research and mixed findings about person and family centred experiences during care transitions and outcomes following transitional care interventions [10, 12, 24, 31, 32, 35–37]. These findings indicate that the older person’s experience and the experiences of their family/carer have not received sufficient attention in the transitional care intervention research to date.…”

The indispensable intermediaries: a qualitative study of informal caregivers’ struggle to achieve influence at and after hospital discharge

“…Involving family members has also been shown to improve the care recipient’s participation in the decision-making process [46,47]. Moreover, it is recognized that informal caregivers’ satisfaction with the discharge process influences the patients’ satisfaction and even influences the patient outcome positively [45].…”

Multi‐professional communication for older people in transitional care: a review of the literature

“…, 2002). It is also described as a complex process reflecting assessment, decision making and care planning, and goal and problem identification (Coleman, 2003; Watts & Gardner, 2005; Coffey, 2006).…”