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Hospital discharge of elderly patients to primary health care, with and without an intermediate care hospital: a qualitative study of health professionals' experiences
- Authors:
- DAHL Unni, et al
- Journal article citation:
- International Journal of Integrated Care, 14(2), 2014, Online only
- Publisher:
- International Foundation for Integrated Care
Introduction: This is a study of an intermediate care hospital established in Central Norway to improve discharge from a general hospital to primary health care. The aim of the study was to investigate how professionals across health care levels experience the discharge of elderly patients, who are in need of continued care, from a general hospital via an intermediate care hospital compared to a direct discharge to primary health care in a municipality without intermediate care. Methods: A qualitative study with data collected through semi-structured focus groups and individual interviews. Results: Discharge via the intermediate care hospital was contrasted favourably compared to discharge directly from hospital to primary health care. Although increased capacity to receive patients from hospital and prepare them for discharge to primary health care was viewed as a benefit, professionals still requested better communication with the preceding care level concerning further treatment and care for the elderly patients. Conclusions: The intermediate care hospital reduced the coordination challenges during discharge of elderly patients from hospital to primary health care. Nevertheless, the intermediate care was experienced more like an extension of hospital than an included part of primary health care and did not meet the need for communication across care levels. (Edited publisher abstract)
SCIE research briefing 12: involving individual older patients and their carers in the discharge process from acute to community care: implications for intermediate care
- Author:
- SOCIAL CARE INSTITUTE FOR EXCELLENCE
- Publisher:
- Social Care Institute for Excellence
- Publication year:
- 2005
- Place of publication:
- London
This web-based briefing provides a concise summary of the research and policy literature into the means, benefits and difficulties of involving patients in the planning of discharge to community or intermediate care. It also considers the role of carers in this process, as well as what happens when an older person’s ability to communicate their preferences in these matters is affected by dementia, language difficulties, or an unwillingness or reluctance to express preferences about the provision of care. The briefing also examines policy and research findings on older people’s involvement in discharge planning more generally. The briefing was commissioned by the Social Care Institute for Excellence (SCIE).
National Audit of Intermediate Care: patient reported experiences, 2015: full report of
- Author:
- ARISS Steven
- Publisher:
- University of Sheffield. School of Health and Related Research
- Publication year:
- 2015
- Pagination:
- 35
- Place of publication:
- Sheffield
Describes the findings from the qualitative analysis of responses for the 2015 National Audit of Intermediate Care (NAIC). The number of responses was down on last year; overall 776 respondents used the free text box to give further information, which compares to 908 respondents in 2014. The following numbers of responses were received for the three types of services: bed based, 302; home-based, 298; and reablement services, 176. Bed-based services are frequently reported to be under-staffed, resulting in limited opportunities for therapeutic activities. Lack of appropriate information was a key issue in all intermediate care services. This is an area where consulting with patients could provide straightforward solutions. In addition, the transition between services is a problematic area for many patients. Often this begins with inadequate consultation with patients and family in bed-based or hospital settings. Poor coordination between services is also problematic for many service-users, and an area where improvements could make a significant difference to many patients’ experiences. The timing of visits for home-based and reablement services is erratic, unpredictable and poorly communicated to patients or their families. This can lead to significant disruption in eating and daily activities, stress and risks of accidents or injury. The report suggests that setting a standard for ‘never’ events could be justified to limit the impact on patients. (Edited publisher abstract)
Rehabilitation services for older people: a bulletin for trusts and social care organisations
- Author:
- DISTRICT AUDIT
- Publisher:
- District Audit
- Publication year:
- 2002
- Pagination:
- 11p.
- Place of publication:
- London
Rehabilitation and preventative services have an essential part to play in helping older people maintain their independence and a good quality of life. Effective rehabilitation services can prevent the need for older people to be admitted to hospital, facilitate their discharge from hospital and reduce their reliance on institutional care or community services. However, rehabilitation services are failing to make the necessary impact: services are unco-ordinated, they do not engage with older people as individuals and so cannot respond to their needs.