Components of a proper hospital discharge for elders

Significance. Effective discharge planning is a vital link in continuity of care for elders. Previous studies identify problems with planning for elde rs' discharge from the hospital and problems elders encounter managing care post-discharge. However, little attention has been given to identifying ef fective discharge planning processes. Explicating the components of effecti ve discharge planning is critical to replicate the process in other health care settings and predict post-discharge outcomes. Purpose. The purpose of this study was to identify the components of effect ive discharge planning for elders and factors that impede planning. Methods. Ethical approvals were obtained from the University and National H ealth Service (NHS) Trust. Qualitative methods were used and data were coll ected from two wards in a 78-bed geriatric rehabilitation hospital that was part of a National Health Service Trust serving Southwest London. Data inc luded semi-structured interviews and documents related to discharge plannin g, care delivery, and community resources. A total of 24 semi-structured in terviews were conducted with health care professionals who were part of the hospital's multidisciplinary team, those affiliated with the Community Tru st that provided aftercare, elders, and family caters. Results. Participants consistently used the term 'proper discharge' when re ferring to effective discharge planning. The multidisciplinary team compris ed a viral context for a proper discharge. The findings indicated that thre e circles of communication were central in a four stage discharge process. Different circles of communication were key at different stages. Conclusions. The findings provide insights for educating nurses about effec tive planning practices and examining the global significance of impediment s to a proper hospital discharge.