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Are patients discharged with care? A qualitative study of perceptions and experiences of patients, family members and care providers
Open accessAbstract
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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“Due to disease progression, patients’ perceptions of their own capability and condition management differed to their carers’ [45, 75].”
From Do hospital-to-home transitions work for older adults with multiple long-term conditions including dementia? A realist review (2025) · cites this paper as [75]
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“This enabled information sharing between carers and HCPs, and improved understanding of patient needs, subsequently impacting their ability to tailor discharge planning (CMOC4) [43, 46, 52, 54, 75, 76].”
From Do hospital-to-home transitions work for older adults with multiple long-term conditions including dementia? A realist review (2025) · cites this paper as [75]
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“Analysis suggested that pressure to comply with the system-level focus on occupancy targets and minimising length of stay further fuelled these beliefs, as older adults with dementia typically stay longer in hospital [41, 43, 48, 50, 75, 78, 84, 89, 91–93].”
From Do hospital-to-home transitions work for older adults with multiple long-term conditions including dementia? A realist review (2025) · cites this paper as [75]
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“Analysis suggested that pressure to comply with the system-level focus on occupancy targets and minimising length of stay further fuelled these beliefs, as older adults with dementia typically stay longer in hospital [41, 43, 48, 50, 75, 78, 84, 89, 91–93].”
From Do hospital-to-home transitions work for older adults with multiple long-term conditions including dementia? A realist review (2025) · cites this paper as [75]
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Metadata
- 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
- 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
- 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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