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Discharge to assess: an evaluation of three case studies in the southeast of England to inform service improvement

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posted on 2024-02-12, 11:31 authored by Stuart Jeffery, Jenny Monkhouse, Lavinia BertiniLavinia Bertini, Susie Walker, Rebecca Sharp

Background

Discharge to Assess (D2A) emerged as a critical process during the COVID-19 pandemic facilitating patient flow within hospitals, however research on the post-discharge community services of this pathway remains limited. We conducted an evaluation to examine the impacts, capacity, processes and barriers associated with D2A and to identify best practice across three sites in the southeast of England.

Methods

We interviewed 29 commissioners, providers and staff members involved in the delivery of D2A pathways within three Health and Care Partnerships. Framework analysis of the collected data revealed three prominent themes: the commissioning of services encompassing funding, structure, culture, and expected outcomes; multidisciplinary collaboration including staff skills, team connections, and coordination; and information and knowledge exchange such as assessment methods, record management, and availability of operational insights.

Results

62 specific enablers and blockers to effective D2A practice emerged.

Discussion

These findings supported the development of a comprehensive service improvement toolkit.

Conclusion

Five recommendations are proposed: 1. Examination of pathways against the 62 enablers and blockers to identify and resolve pathway obstacles; 2. Establish a local operational policy accessible to all providers; 3. Enhance coordination and communication among service providers, patients and carers; 4. Strengthen oversight of service user flow; 5. Develop a consistent Patient Reported Outcomes Measure to facilitate feedback and service enhancements for individuals discharged from urgent care pathways.

History

Publication status

  • Published

File Version

  • Published version

Journal

BMJ Open Quality

ISSN

2399-6641

Publisher

BMJ

Volume

12

Article number

e002515

Department affiliated with

  • Primary Care and Public Health Publications
  • BSMS Publications

Institution

University of Sussex

Full text available

  • Yes

Peer reviewed?

  • Yes