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Identifying the barriers and facilitators may help in the design of effective solutions for improving the discharge process.
This may improve patients’/families’ self-care skills (eg, improving medication adherence), mitigate patient anxiety, and reduce avoidable and costly readmissions.
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, This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license.
Regular conference calls were held to refine the codebook as codes arose during the analyses and to group the codes that were related to the same phenomenon into unique categories. The same two researchers further analysed the data in each country until conceptual saturation was reached for that country, that is, no new codes or categories were generated.35 Local analyses were used to report on patient-centred care and the culture36 and to explore the barriers and facilitators to patient-centred care in the discharge process.
Three researchers (GH, HW and MF) synthesised these findings.37 The categories and themes identified across the different settings were verified with the researchers from each country and an additional number of quotes from each country were provided to illustrate the findings.
Ethics approval was received at each of the five study sites.Patients, despite the recently increased focus on patient-centredness, often leave the hospital unprepared for postdischarge demands.21–23 A recent survey of patients with complex care needs in 11 countries reported that one in four did not receive instructions for follow-up nor did they receive clear medication directions.24 Other studies have demonstrated that patients and family members express anxiety and a sense of abandonment after discharge.25–27 Patient unpreparedness, anxiety and a misunderstanding of the full ramifications of their situation at discharge are believed to increase hospital readmissions and adverse events in the posthospital setting.This is especially the case for the elderly and those with chronic conditions who require frequent transitions between hospital and home care.28–31 There is little understanding about the factors that facilitate or create barriers to patient-centred care at hospital discharge.The BHUDRH encourages experienced academic staff to spend time in rural and remote communities and foster partnerships to improve the quality of health care for rural Australians.The Department’s research and development team provide comprehensive research training for general practitioners, primary health care workers, Indigenous mental health trainees and professional development support for local health professionals in our region.