Who cares? A focus group study on follow up care after discharge from hospital

To ascertain general practitioners', patients' and hospital staff's perspectives on post discharge problems and other problems related to hospital liaison in the Darwin urban area. To identify stakeholders who have a role in addressing these problems and develop locally appropriate responses to improve post hospital discharge patient care.

A qualitative study using three focus groups was conducted with seven GPs, six ex-patients of the study hospital and 11 hospital staff. The problems and proposed strategies identified by these groups were then fed back to stakeholders for comment in order to generate recommendations to improve post discharge care.

The main themes generated were: lack of recognition of the potential role of the GP and patient by the hospital; poor communication between the hospital, GPs and patients; and, lack of resources to improve information flow. Specifically, 'not being listened to' by hospital doctors, nurses and GPs was a major theme of the patient focus group and was equated with a 'not caring' attitude by some hospital staff and GPs. Twelve strategies were generated by the focus groups with considerable overlap of issues. The main strategies were aimed at GP liaison by providing GPs and patients with timely, adequate and comprehensible information as part of their 'duty of care'. General practitioners, however, need to provide legible, relevant and concise referral letters to facilitate this process.

This study highlights the need for improved communication between the GP and the hospital to redress the lack of recognition of GPs. The appointment of a GP/hospital liaison officer in the study hospital could address this issue as well as others of patient empowerment and advocacy, and partnerships in health care. This project has also highlighted the importance of consulting patients and the value of their perspective to complement GP and hospital viewpoints.