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 towhich care providers arewilling
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 afocus on improving
communication among care providers, patients and families,
and between hospital and community care providers.

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Identifiers

ORCID for Lisette Schoonhoven: orcid.org/0000-0002-7129-3766

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