CoChat
Sign Up
Cited by 99Health Services Management and PolicyEmergency and Acute Care StudiesHealthcare Operations and Scheduling Optimization

Systems and people under pressure: the discharge process in an acute hospital

Connolly, Michael, Grimshaw, Jane, Dodd, Mary, Cawthorne, Julie, Hulme, Tarnya, Everitt, Sarah, Tierney, Stephanie, Deaton, Christi·2009·Journal of Clinical Nursing
DOI 10.1111/j.1365-2702.2008.02551.x
Open this paper in CoChat — free account

Abstract

Aims. To understand the perspective of hospital‐based health professionals with regard to preparing patients for discharge from an acute hospital in England. Background. The hospital experience in England over recent years is characterised by increasing admission rates and decreasing length of stay. Legislation and policy initiatives have also focussed upon the need to reduce delayed discharges. Discharge preparation is known to be a complex intervention with multiple obstacles within and outside of the hospital setting. Design. Qualitative. Methods. Posters were displayed within a hospital asking health professionals to take part in a focus group. Maximum variation, in terms of job titles, was sought for within the sample. Focus groups were held in December 2006. Six senior members of staff divided into pairs to run them. All groups were taped and transcribed verbatim and analysed using a framework approach. Results. Three focus groups were conducted, which involved 11 nurses, 15 allied health professionals, five social workers and one doctor. Analysis identified the following themes and sub themes: Conflicting pressures on staff: Casualties arising from conflicting pressures: Conclusions. Pressures described during focus groups stemmed from five main sources: external targets placed upon the system, internal hospital inflexibility and poor communication, the dominance of the medical model of care, a desire to address the complex needs of individuals and a lack of community services. Staff felt themselves to be victims of these competing pressures and that many of the solutions were beyond their influence. Staff described the dehumanising effect of sometimes having to ignore patient concerns, wishes and choices. Relevance to clinical practice. Understanding of the pressures surrounding discharge could inform relevant service improvements.

Integrity signals

Registry

Crossref · 10.1111/j.1365-2702.2008.02551.x

Cites

18 of 18 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • An English study by Connolly et al. reported practitioners were conflicted by competing internal and external pressures, which undermined their professionalism, caused frustration, and resulted in de-personalisation of care.

    “Findings of this review echo those in an English study by Connolly et al. [46], who reported practitioners were conflicted by competing internal and external pressures, which undermined their professionalism, caused frustration, and resulted in de-personalisation of care.”

    From Stakeholder perspectives of care for people living with dementia moving from hospital to care facilities in the community: a systematic review (2019) · cites this paper as [46]

Cites

Flagged first, then by citations

Cited by

Sorted by citations

Related

Authors
Connolly, M., Grimshaw, J., Dodd, M., Cawthorne, J., Hulme, T., Everitt, S., Tierney, S., & Deaton, C.
Affiliations
University of Manchester (GB)
Corresponding author
Connolly, Michael
ORCID
Venue
Journal of Clinical Nursing
Publisher
Wiley
Published
2009-01-14
Volume
18
Issue
4
Pages
549-558
ISSN
  • 0962-1067 (ISSN-L)
  • 1365-2702
DOI
10.1111/j.1365-2702.2008.02551.x
OpenAlex
W2160280033
Cited by
99
References
18
Citations by year
2026: 2 · 2025: 3 · 2024: 2 · 2023: 1 · 2022: 3 · 2021: 6 · 2020: 2 · 2019: 5 · 2018: 10 · 2017: 10 · 2016: 9 · 2015: 10 · 2014: 4 · 2013: 4 · 2012: 9
FWCI
16.95
Type
journal article
Language
en
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Journal of Clinical Nursing (publishedVersion)
  • PubMed (publishedVersion)
  • Research Explorer (The University of Manchester) (submittedVersion)
Topics
  • Health Sciences › Health Professions › General Health Professions › Health Services Management and Policy
  • Health Sciences › Medicine › Emergency Medicine › Emergency and Acute Care Studies
  • Health Sciences › Health Professions › Emergency Medical Services › Healthcare Operations and Scheduling Optimization
Keywords
hospital discharge, discharge preparation, acute hospital care, delayed discharge, length of hospital stay, professional boundaries, medical model of care, community service, patient-centered care, dehumanization, health professionals' perspectives
MeSH terms
England, Patient Discharge, Focus Groups

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review