Are patients discharged with care?: A qualitative study of perceptions and experiences of patients, family members and care providers

Gijs Hesselink; Maria Flink; Mariann Olsson; Paul Barach; Ewa Dudzik-Urbaniak; Carola Orrego; Giulio Toccafondi; Cor Kalkman; Julie K Johnson; Lisette Schoonhoven; Myrra Vernooij-Dassen; Hub Wollersheim; European HANDOVER Research Collaborative

doi:10.1136/bmjqs-2012-001165

Are patients discharged with care? A qualitative study of perceptions and experiences of patients, family members and care providers

Gijs Hesselink, Maria Flink, Mariann Olsson, Paul Barach, Ewa Dudzik-Urbaniak, Carola Orrego, Giulio Toccafondi, Cor Kalkman, Julie K Johnson, Lisette Schoonhoven, Myrra Vernooij-Dassen, Hub Wollersheim, European HANDOVER Research Collaborative

Research output: Contribution to journal › Article › peer-review

97 Citations (Scopus)

Abstract

BACKGROUND: Advocates for quality and safety have called for healthcare that is patient-centred and decision-making that involves patients.

OBJECTIVE: The aim of the paper is to explore the barriers and facilitators to patient-centred care in the hospital discharge process.

METHODS: A qualitative study using purposive sampling of 192 individual interviews and 26 focus group interviews was conducted in five European Union countries with patients and/or family members, hospital physicians and nurses, and community general practitioners and nurses. A modified Grounded Theory approach was used to analyse the data.

RESULTS: The barriers and facilitators were classified into 15 categories from which four themes emerged: (1) healthcare providers do not sufficiently prioritise discharge consultations with patients and family members due to time restraints and competing care obligations; (2) discharge communication varied from instructing patients and family members to shared decision-making; (3) patients often feel unprepared for discharge, and postdischarge care is not tailored to individual patient needs and preferences; and (4) pressure on available hospital beds and community resources affect the discharge process.

CONCLUSIONS: Our findings suggest that involvement of patients and families in the preparations for discharge is determined by the extent to which care providers are willing and able to accommodate patients' and families' capabilities, needs and preferences. Future interventions should be directed at healthcare providers' attitudes and their organisation's leadership, with a focus on improving communication among care providers, patients and families, and between hospital and community care providers.

Original language	English
Pages (from-to)	i39-49
Journal	BMJ Quality & Safety
Volume	21 Suppl 1
DOIs	https://doi.org/10.1136/bmjqs-2012-001165
Publication status	Published - Dec 2012
Externally published	Yes

Keywords

Adult
Chronic Disease
Cross-Cultural Comparison
Decision Making
Efficiency, Organizational
European Union
Family
Focus Groups
Health Knowledge, Attitudes, Practice
Health Personnel
Health Services Needs and Demand
Humans
Interviews as Topic
Patient Discharge
Patient Handoff
Patient-Centered Care
Patients
Qualitative Research

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10.1136/bmjqs-2012-001165

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Hesselink, G., Flink, M., Olsson, M., Barach, P., Dudzik-Urbaniak, E., Orrego, C., Toccafondi, G., Kalkman, C., Johnson, J. K., Schoonhoven, L., Vernooij-Dassen, M., Wollersheim, H., & European HANDOVER Research Collaborative (2012). Are patients discharged with care? A qualitative study of perceptions and experiences of patients, family members and care providers. BMJ Quality & Safety, 21 Suppl 1, i39-49. https://doi.org/10.1136/bmjqs-2012-001165

@article{ee793f651f174830bc1d05741c2581bd,

title = "Are patients discharged with care?: A qualitative study of perceptions and experiences of patients, family members and care providers",

abstract = "BACKGROUND: Advocates for quality and safety have called for healthcare that is patient-centred and decision-making that involves patients.OBJECTIVE: The aim of the paper is to explore the barriers and facilitators to patient-centred care in the hospital discharge process.METHODS: A qualitative study using purposive sampling of 192 individual interviews and 26 focus group interviews was conducted in five European Union countries with patients and/or family members, hospital physicians and nurses, and community general practitioners and nurses. A modified Grounded Theory approach was used to analyse the data.RESULTS: The barriers and facilitators were classified into 15 categories from which four themes emerged: (1) healthcare providers do not sufficiently prioritise discharge consultations with patients and family members due to time restraints and competing care obligations; (2) discharge communication varied from instructing patients and family members to shared decision-making; (3) patients often feel unprepared for discharge, and postdischarge care is not tailored to individual patient needs and preferences; and (4) pressure on available hospital beds and community resources affect the discharge process.CONCLUSIONS: Our findings suggest that involvement of patients and families in the preparations for discharge is determined by the extent to which care providers are willing and able to accommodate patients' and families' capabilities, needs and preferences. Future interventions should be directed at healthcare providers' attitudes and their organisation's leadership, with a focus on improving communication among care providers, patients and families, and between hospital and community care providers.",

keywords = "Adult, Chronic Disease, Cross-Cultural Comparison, Decision Making, Efficiency, Organizational, European Union, Family, Focus Groups, Health Knowledge, Attitudes, Practice, Health Personnel, Health Services Needs and Demand, Humans, Interviews as Topic, Patient Discharge, Patient Handoff, Patient-Centered Care, Patients, Qualitative Research",

author = "Gijs Hesselink and Maria Flink and Mariann Olsson and Paul Barach and Ewa Dudzik-Urbaniak and Carola Orrego and Giulio Toccafondi and Cor Kalkman and Johnson, {Julie K} and Lisette Schoonhoven and Myrra Vernooij-Dassen and Hub Wollersheim and {European HANDOVER Research Collaborative}",

year = "2012",

month = dec,

doi = "10.1136/bmjqs-2012-001165",

language = "English",

volume = "21 Suppl 1",

pages = "i39--49",

journal = "BMJ Quality & Safety",

issn = "2044-5415",

publisher = "BMJ Publishing Group",

}

Hesselink, G, Flink, M, Olsson, M, Barach, P, Dudzik-Urbaniak, E, Orrego, C, Toccafondi, G, Kalkman, C, Johnson, JK, Schoonhoven, L, Vernooij-Dassen, M, Wollersheim, H & European HANDOVER Research Collaborative 2012, 'Are patients discharged with care? A qualitative study of perceptions and experiences of patients, family members and care providers', BMJ Quality & Safety, vol. 21 Suppl 1, pp. i39-49. https://doi.org/10.1136/bmjqs-2012-001165

TY - JOUR

T1 - Are patients discharged with care?

T2 - A qualitative study of perceptions and experiences of patients, family members and care providers

AU - Hesselink, Gijs

AU - Flink, Maria

AU - Olsson, Mariann

AU - Barach, Paul

AU - Dudzik-Urbaniak, Ewa

AU - Orrego, Carola

AU - Toccafondi, Giulio

AU - Kalkman, Cor

AU - Johnson, Julie K

AU - Schoonhoven, Lisette

AU - Vernooij-Dassen, Myrra

AU - Wollersheim, Hub

AU - European HANDOVER Research Collaborative

PY - 2012/12

Y1 - 2012/12

N2 - BACKGROUND: Advocates for quality and safety have called for healthcare that is patient-centred and decision-making that involves patients.OBJECTIVE: The aim of the paper is to explore the barriers and facilitators to patient-centred care in the hospital discharge process.METHODS: A qualitative study using purposive sampling of 192 individual interviews and 26 focus group interviews was conducted in five European Union countries with patients and/or family members, hospital physicians and nurses, and community general practitioners and nurses. A modified Grounded Theory approach was used to analyse the data.RESULTS: The barriers and facilitators were classified into 15 categories from which four themes emerged: (1) healthcare providers do not sufficiently prioritise discharge consultations with patients and family members due to time restraints and competing care obligations; (2) discharge communication varied from instructing patients and family members to shared decision-making; (3) patients often feel unprepared for discharge, and postdischarge care is not tailored to individual patient needs and preferences; and (4) pressure on available hospital beds and community resources affect the discharge process.CONCLUSIONS: Our findings suggest that involvement of patients and families in the preparations for discharge is determined by the extent to which care providers are willing and able to accommodate patients' and families' capabilities, needs and preferences. Future interventions should be directed at healthcare providers' attitudes and their organisation's leadership, with a focus on improving communication among care providers, patients and families, and between hospital and community care providers.

AB - BACKGROUND: Advocates for quality and safety have called for healthcare that is patient-centred and decision-making that involves patients.OBJECTIVE: The aim of the paper is to explore the barriers and facilitators to patient-centred care in the hospital discharge process.METHODS: A qualitative study using purposive sampling of 192 individual interviews and 26 focus group interviews was conducted in five European Union countries with patients and/or family members, hospital physicians and nurses, and community general practitioners and nurses. A modified Grounded Theory approach was used to analyse the data.RESULTS: The barriers and facilitators were classified into 15 categories from which four themes emerged: (1) healthcare providers do not sufficiently prioritise discharge consultations with patients and family members due to time restraints and competing care obligations; (2) discharge communication varied from instructing patients and family members to shared decision-making; (3) patients often feel unprepared for discharge, and postdischarge care is not tailored to individual patient needs and preferences; and (4) pressure on available hospital beds and community resources affect the discharge process.CONCLUSIONS: Our findings suggest that involvement of patients and families in the preparations for discharge is determined by the extent to which care providers are willing and able to accommodate patients' and families' capabilities, needs and preferences. Future interventions should be directed at healthcare providers' attitudes and their organisation's leadership, with a focus on improving communication among care providers, patients and families, and between hospital and community care providers.

KW - Adult

KW - Chronic Disease

KW - Cross-Cultural Comparison

KW - Decision Making

KW - Efficiency, Organizational

KW - European Union

KW - Family

KW - Focus Groups

KW - Health Knowledge, Attitudes, Practice

KW - Health Personnel

KW - Health Services Needs and Demand

KW - Humans

KW - Interviews as Topic

KW - Patient Discharge

KW - Patient Handoff

KW - Patient-Centered Care

KW - Patients

KW - Qualitative Research

U2 - 10.1136/bmjqs-2012-001165

DO - 10.1136/bmjqs-2012-001165

M3 - Article

C2 - 23118410

SN - 2044-5415

VL - 21 Suppl 1

SP - i39-49

JO - BMJ Quality & Safety

JF - BMJ Quality & Safety

ER -

Are patients discharged with care? A qualitative study of perceptions and experiences of patients, family members and care providers

Abstract

Keywords

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