['Let Them Deal With It' - Interview Results From Follow-Up Care Provider Surveys In The 'Überpflege' Project]

Discharge management and transitional care are key interfaces within the German healthcare system. Nevertheless, there remain significant gaps in the transition of patients from hospital to post-discharge care. In the project "ÜberPflege - Care-centred transitional care in hospital to reduce post-discharge bottlenecks following inpatient treatment within the framework of discharge management", eleven guideline-based interviews were conducted with representatives of post-discharge care facilities and analysed using Kuckartz's content analysis method. The results reveal clear shortcomings in the quality of information, communication and cross-sectoral coordination. Information relevant to nursing is frequently missing or transmitted late, and digital structures are scarcely established. Transition care is regarded as fundamentally beneficial, but is used only to a limited extent in practice. Successful transitions depend largely on nursing-led coordination and interface competence. The findings underscore the need to involve nursing staff more closely in discharge and handover processes.