Cited by 203Patient-Provider Communication in HealthcarePatient Satisfaction in HealthcareHospital Admissions and Outcomes

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

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Hesselink, Gijs, Flink, Maria, Olsson, Mariann, Barach, Paul, Dudzik-Urbaniak, Ewa, Orrego, Carola, Toccafondi, Giulio, Kalkman, Cor, Johnson, Julie K, Schoonhoven, Lisette, Vernooij-Dassen, Myrra, Wollersheim, Hub, on behalf of the European HANDOVER Research Collaborative·2012·BMJ Quality & Safety

DOI 10.1136/bmjqs-2012-001165

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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.

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Authors: 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., & Collaborative, O. B. O. T. E. H. R.
Affiliations: Radboud University Medical Center (NL)
Karolinska University Hospital (SE)
University College Cork (IE)
National Center for Quality Assessment in Health Care, Krakow, Poland
Universitat Autònoma de Barcelona (ES)
Regione Toscana (IT)
University Medical Center Utrecht (NL)
UNSW Sydney (AU)
Corresponding author: Hesselink, Gijs
ORCID: Hesselink, Gijs
Flink, Maria
Olsson, Mariann
Barach, Paul
Orrego, Carola
Toccafondi, Giulio
Kalkman, Cor
Johnson, Julie K
Schoonhoven, Lisette
Vernooij-Dassen, Myrra
Venue: BMJ Quality & Safety
Publisher: BMJ
Published: 2012-11-01
Volume: 21
Issue: Suppl 1
Pages: i39-i49
ISSN: 1475-3898 (ISSN-L)
2044-5415
2044-5423
DOI: 10.1136/bmjqs-2012-001165
OpenAlex: W2099043395
Cited by: 203
References: 56
Citations by year: 2026: 5 · 2025: 16 · 2024: 25 · 2023: 13 · 2022: 15 · 2021: 15 · 2020: 18 · 2019: 17 · 2018: 20 · 2017: 20 · 2016: 9 · 2015: 9 · 2014: 9 · 2013: 9 · 2012: 2
FWCI: 16.45
Type: journal article
Language: en
Open access: hybrid
doi.org
Licence: cc-by-nc
Locations: BMJ Quality & Safety (publishedVersion, cc-by-nc)
PubMed (publishedVersion)
ePrints Soton (University of Southampton) (acceptedVersion)
Dipòsit Digital de Documents de la UAB (Universitat Autònoma de Barcelona) (submittedVersion, cc-by-nc)
HighWire Press Open Archive (submittedVersion)
Radboud Repository (Radboud University) (submittedVersion)
Funders: European Commission (223409)
FP7 Health
Topics: Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
Health Sciences › Health Professions › General Health Professions › Patient Satisfaction in Healthcare
Health Sciences › Nursing › Leadership and Management › Hospital Admissions and Outcomes
Keywords: hospital discharge, patient-centered care, shared decision-making, discharge communication, barriers and facilitators, patient and family involvement, post-discharge care, hospital bed pressure, hospital-community care transition, patient readiness, clinician attitudes
MeSH terms: Adult, Chronic Disease, Cross-Cultural Comparison, Decision Making, European Union, Family, Health Personnel, Health Services Needs and Demand, Humans, Interviews as Topic, Health Knowledge, Attitudes, Practice, Patient Discharge, Patients, Focus Groups, Efficiency, Organizational, Patient-Centered Care, Qualitative Research, Patient Handoff

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

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