Home to the unknown: getting hospital discharge right

This research explored patients’ unplanned stays in hospital and what it was like for them after they had returned home | British Red Cross

The research sought to reveal: patients’ experiences of being discharged from hospital; hospital systems and healthcare professionals’ experiences and perceptions of the discharge process; and what it was like for people returning home from hospital feeling more or less prepared.

As a result, it aimed to explore the impact of discharge on recovery and wellbeing and to identify opportunities to improve systems, communication and support.

Based on the experience of the British Red Cross and the research, the report argues:

  1. There is a substantial opportunity for commissioners and providers to harness the power of non-clinical support, including the voluntary and community sector (VCS), to relieve the pressure on the NHS and to create better outcomes for people and improved patient flow within and between health and social care providers.
  2. Every point of hand-off between clinical teams in hospital and from the hospital to the community is a potential point of success or failure for patient recovery. The report recommends that there is a clinical responsibility to ensure the effective management of these transitions, so that there is continuity of care and patients don’t fall through the gaps between teams.
  3. The report recommends that a five part ‘independence check’ should be completed as part of an improved approach to patient discharge – prior to discharge or within 72 hours of going home. This would help to inform the setting of a realistic discharge date and would include assessing:
  • Practical independence (for example, suitable home environment and adaptations)
  • Social independence (for example, risk of loneliness and social isolation, if they have meaningful connections and support networks)
  • Psychological independence (for example, how they are feeling about going home, dealing with stress associated with injury)
  • Physical independence (for example, washing, getting dressed, making tea) and mobility (for example, need for a short-term wheelchair loan)
  • Financial independence (for example, ability to cope with financial burdens).
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