Case Study: discharge decision making for older people
Research type
Research Study
Full title
The process of discharge decision making for older people returning to the community from a general hospital short stay unit: a case study
IRAS ID
152409
Contact name
Annabel Rule
Contact email
Sponsor organisation
University of Southampton
Research summary
The discharge process from short stay units in acute general hospitals is multi-faceted, fast paced and involves the co-ordination of many health professionals, family members and services. For older people, who are more likely to have complex needs, the process can become even more convoluted. A discharge that is unsuccessful can often lead to readmission, reduced confidence and a longer hospital stay.
There are consistent reports that older people do not feel involved in their care or the decisions made regarding discharge. This is contrary to best practice guidelines that dictate a shared decision making approach as best practice to improve the patient experience.
This qualitative research aims to understand and unpick the complex process of discharge decision making for older people being discharged from a short stay unit. Through a case study approach, semi-structured interviews with patients who are over 65 and their relatives will be carried out during the hospital stay and 1-7 days after discharge. Additionally, assessments, meetings and discharge discussions will be directly observed regarding those patients' discharges. Following these observations, extracts of patient participant's ward based paper records written by hospital staff regarding the observed assessment/intervention will be transcribed and analysed for greater understanding. In addition, focus groups with health professionals will be used to gather their perceptions, thoughts on and experiences of the discharge process and explore emerging themes.
This will be carried out throughout three data collection phases. Phase 1 where piloting and initial exploration will take place, phase 2, in-depth exploration and phase 3, follow up exploration. Approximately 10-20 older people, 10-20 relatives and 10-20 health professionals will be purposively sampled. Verbatim transcripts of interviews and focus groups, direct observation field notes and extracts of patient notes will be analysed using inductive content analysis.REC name
Yorkshire & The Humber - South Yorkshire Research Ethics Committee
REC reference
14/YH/1102
Date of REC Opinion
31 Jul 2014
REC opinion
Further Information Favourable Opinion