‘Are decisions about dischargeof elderly hospital patients mainlyabout freeing blocked beds?’: A qualitative observational study
2012 (English)In: BMJ. British Medical Journal, ISSN 0959-535X, E-ISSN 1756-1833, Vol. 2, no 6, 1-9 p.Article in journal (Refereed) Published
Objective: To explore the interactions concerning thefrail and elderly patients having to do with dischargefrom acute hospital wards and their participation inmedical decision-making. The views of the patients andthe medical staff were both investigated.
Design: A qualitative observational and interviewstudy using the grounded theory.
Setting and participants: The setting was threehospitals in rural and urban areas of two counties inSweden of which one was a teaching hospital. The datacomprised observations, healthcare staff interviews andpatient interviews. The selected patients were all aboutto be informed that they were going to be discharged.
Results: The patients were seldom invited toparticipate in the decision-making regarding discharge.Generally, most communications regarding dischargewere between the doctor and the nurse, after which thepatient was simply informed about the decision. It wasobserved that the discharge information was oftengiven in an indirect way as if other, albeit absent,people were responsible for the decision. Interviewswith the healthcare staff revealed their preoccupationwith the need to free up beds: ‘thinking aboutdischarge planning all the time’ was the core category.This focus not only failed to fulfil the complex needs ofelderly patients, it also generated feelings of frustrationand guilt in the staff, and made the patients feelunwelcome.
Conclusions: Frail elderly patients often did notparticipate in the medical decision-making regardingtheir discharge from hospital. The staff was highlyfocused on patients getting rapidly discharged, whichmade it difficult to fulfil the complex needs of thesepatients.
Place, publisher, year, edition, pages
2012. Vol. 2, no 6, 1-9 p.
Frail elderly, Patient Participation, Discharge Planning, Qualitative observational study, Grounded theory, Hospital
Medical and Health Sciences
IdentifiersURN: urn:nbn:se:liu:diva-81401DOI: 10.1136/bmjopen-2012-002027ISI: 000315081400135OAI: oai:DiVA.org:liu-81401DiVA: diva2:552241
On the day of the defence date the title of this article was: “Focusing on acquiring available beds!” : The process of discharging elderly patients: A qualitative observational study.2012-09-132012-09-132015-06-10