The Library
Discharge communication study : a realist evaluation of discharge communication experiences of patients, general practitioners and hospital practitioners, alongside a corresponding discharge letter sample
Tools
Weetman, Katharine, Dale, Jeremy, Scott, Emma and Schnurr, Stephanie (2021) Discharge communication study : a realist evaluation of discharge communication experiences of patients, general practitioners and hospital practitioners, alongside a corresponding discharge letter sample. BMJ Open, 11 . e045465. doi:10.1136/bmjopen-2020-045465 ISSN 2044-6055.
|
PDF
WRAP-discharge-communication-study-realist-evaluation-2021.pdf - Published Version - Requires a PDF viewer. Available under License Creative Commons Attribution 4.0. Download (1361Kb) | Preview |
Official URL: http://dx.doi.org/10.1136/bmjopen-2020-045465
Abstract
Objectives: To develop a programme theory for the intervention of patients receiving discharge letters.
Design: We used a realist evaluation approach and captured multiple perspectives of hospital discharge to refine our previously developed programme theory. General practitioner (GP), patient and hospital clinician views of a single discharge event in which they were all involved were collected using semi-structured interviews and surveys. These were then triangulated to match the corresponding discharge letter. Data were qualitatively synthesised and compared in meta-matrices before interrogation with realist logic of analysis to develop the programme theory that maps out how patients receiving discharge letters works in specific contexts.
Setting: 14 GP practices and four hospital trusts in West Midlands, UK.
Participants: 10 complete matched cases (GP, patient and hospital practitioner), and a further 26 cases in which a letter was matched with two out of the three participants.
Results: We identified seven context mechanism outcome configurations not found through literature searching. These related to the broad concepts of: patient preference for receiving letters, patient comprehension of letters, patient-directed letters, patient harm and clinician views on patients receiving letters. ‘Patient choice’ was important to the success (or not) of the intervention. Other important contexts for positive effects included: letters written in plain English, lay explanations for jargon, verbal information also provided, no new information in letter and patient choice acknowledged. Three key findings were: patient understanding is perhaps greater than clinicians perceive, clinician attitudes are a barrier to patients receiving letters and that, negative outcomes more commonly manifested when patients had not received letters, rather than when they had.
Conclusions: We suggest how patients receiving discharge letters could be improved to enhance patient outcomes. Our programme theory has potential for use in different healthcare contexts and as a framework for policy development relating to patient discharge.
Item Type: | Journal Article | |||||||||
---|---|---|---|---|---|---|---|---|---|---|
Subjects: | R Medicine > R Medicine (General) R Medicine > RA Public aspects of medicine |
|||||||||
Divisions: | Faculty of Social Sciences > Centre for Applied Linguistics Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
|||||||||
Library of Congress Subject Headings (LCSH): | Hospitals -- Admission and discharge , Patient discharge instructions , Communication in medicine | |||||||||
Journal or Publication Title: | BMJ Open | |||||||||
Publisher: | BMJ | |||||||||
ISSN: | 2044-6055 | |||||||||
Official Date: | 21 July 2021 | |||||||||
Dates: |
|
|||||||||
Volume: | 11 | |||||||||
Article Number: | e045465 | |||||||||
DOI: | 10.1136/bmjopen-2020-045465 | |||||||||
Status: | Peer Reviewed | |||||||||
Publication Status: | Published | |||||||||
Access rights to Published version: | Open Access (Creative Commons) | |||||||||
Date of first compliant deposit: | 29 July 2021 | |||||||||
Date of first compliant Open Access: | 30 July 2021 | |||||||||
RIOXX Funder/Project Grant: |
|
|||||||||
Open Access Version: |
Request changes or add full text files to a record
Repository staff actions (login required)
View Item |
Downloads
Downloads per month over past year