Defining ready for discharge from sub-acute care: a qualitative exploration from multiple stakeholder perspectives

Area of Science:

• Gerontology and Healthcare Management
• Rehabilitation Medicine
• Health Services Research

Background:

• Discharge planning from subacute care is complex, exacerbated by an aging population and service demands.
• Current discharge readiness assessments rely on clinician judgment, influenced by systemic and interpersonal factors.
• Existing literature predominantly focuses on clinician perspectives and acute care settings.

Purpose of the Study:

• To explore the perceptions of discharge readiness from multiple stakeholder viewpoints in subacute care.
• To investigate patient, family, clinician, and manager perspectives on factors influencing discharge readiness.

Main Methods:

• A qualitative descriptive study design was employed.
• Semi-structured interviews and focus groups were conducted with 16 inpatients, 16 family members, 17 clinicians, and 12 managers.
• Inductive thematic analysis was performed on transcribed data.

Main Results:

• Patient-related factors influencing discharge readiness include continence, functional mobility, cognition, pain management, and medication management skills.
• Environmental factors encompass the safety of the home physical environment and the presence of robust social support.
• Social support can compensate for deficits in patient-related functional capabilities.

Conclusions:

• This study offers a comprehensive, multi-stakeholder perspective on discharge readiness in subacute care.
• Identified personal and environmental factors can inform streamlined discharge readiness assessments.
• Further research is needed to explore the assessment of these factors within discharge pathways.