Stakeholder perceptions of a new model of care for medication supply at hospital discharge.

OBJECTIVES: Problems relating to patients' medication are common during hospital discharge, often resulting in unnecessary harm to patients and even hospital readmission. To overcome these issues and improve patient discharge, an evidence-based approach was used to develop an innovative model of care for the supply of medication at hospital discharge. The model increases pharmacy involvement, uses community pharmacies in the supply process and encourages patient follow-up after discharge. This study aimed to determine if the proposed new model of care was considered feasible and acceptable by the target population. METHODS: This formative evaluation involved qualitative interviews and focus groups to explore the opinions of stakeholders involved in delivery or use of the new model of care. A range of stakeholders participated, including a variety of hospital and community-based healthcare professionals as well as expert patients and carers. Thematic analysis of the data was undertaken. RESULTS: The study provided a holistic overview of stakeholder perceptions of the new model of care. Overall, stakeholders were enthusiastic about the new model. Three themes emerged during analysis, providing an informative review of the new model. Themes included: impact, resources required and ensuring safety and quality of the new model of care. Potential issues were identified within each theme along with ideas for overcoming these issues. CONCLUSIONS: The new model of care appears to be a positive step towards improving patient discharge from hospital. Future work will involve a pilot of the new model of care using the study findings to assist with implementation.

Hospital patient discharge process: an evaluation.

OBJECTIVES: Medication discrepancies for patients after discharge from hospital are well documented. They have been shown to cause unnecessary harm to patients and can result in hospital readmission. To improve patient discharge, the current process of discharging patients from hospital (the discharge process) needs evaluating to determine where and why medication issues occur. This study aimed to identify and evaluate the discharge process used in a range of acute National Health Service hospitals across the North West of England. METHODS: This qualitative study involved semi-structured telephone interviews with 13 chief pharmacists or an appropriately nominated member of the hospital pharmacy team. Thematic analysis of the transcribed interview data was performed. Data analysis revealed eight main themes which all impacted on the discharge process. RESULTS: The study was successful in identifying the discharge process across the range of hospitals as well as key issues and examples of good practice. The hospitals involved in the study were found to have similar discharge processes with issues common to all. One significant finding was a lack of patient involvement in the discharge process. CONCLUSIONS: To improve the patient discharge process, innovative solutions are required to overcome the current issues. In future work, the study findings will be used to develop a new model of care for patient discharge from hospital.

UK hospital patient discharge: the patient perspective.

OBJECTIVES: Hospital discharge is a complex process that can result in errors and delays for patients, particularly around the supply of medicines and communication of information. To improve patient discharge, patient perspectives of the discharge service must be explored to determine where patients feel problems arise. This study aimed to explore inpatient perceptions and experiences of the current discharge process. METHODS: This study involved questionnaires with patients at a large city-centre teaching hospital. RESULTS: A total of 104 inpatients participated, 60% (n=62) were male with an average age of 55 (age range 19-93). Participants were from a range of medical, surgical and admissions wards. The majority, 71% of respondents (n=74), took regular medicines, with 65% (n=48) taking five or more medicines daily. Most patients, 89% (n=87), were satisfied with their hospital discharge but felt that it took too long. The perceived main cause of delay was waiting for medicines. Other highlighted issues included lack of counselling by pharmacists and the need for more patient involvement throughout the discharge process. CONCLUSIONS: This study showed that certain aspects of the discharge process need improving to provide safe, quality care for patients and improve patient experience of discharge. The findings from this study will inform the development of a new model of care for patient discharge from hospital.