Patient experiences of hospital discharge: The Dudley Group Foundation NHS Trust Russells Hall Hospital
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In the summer of 2014 Healthwatch Dudley undertook questionnaire survey work at the Russells Hall Hospital as part of the Healthwatch England inquiry into safe discharge in different care settings.
A semi-structured questionnaire survey was used to collect patient views and experiences of discharge from hospital. In total 500 questionnaire surveys were handed out by nursing staff to patients being discharged over a week long period. It was partially or fully completed by 85 patients.
Most felt they understood why they were in hospital and what was happening to them. There were high levels of satisfaction with the care provided in hospital. But there were some patients who were less certain about being ready to leave hospital. The majority of patients felt there had been adequate discussions of discharge procedures although there was scope to improve staff and patient communications and the extent to which all patients feel listened to by hospital staff. A number of patients indicated lower levels of satisfaction with the extent to which they had been involved in decisions about what was happening to them or had concerns about the extent to which family members had been involved in decisions about their care and discharge. It is pertinent to reflect on the extent to which these levels of satisfaction might, where appropriate, be improved.
In terms of care plans (for patients who felt they were relevant for them) a number indicated they did not have one (and may not have needed one). It is necessary to ensure communications work well with patients including those who feel they should have a care plan but do not actually need one to reassure them that their care needs are being met.
Some patients had to wait a considerable time to get their medications from the hospital pharmacy that they needed before being discharged or had concerns about ongoing medical, equipment, therapy and help at home needs being met after they were discharged.
Most patients felt they understood why they were in hospital and what was happening to them and were satisfied with the care they received. Often problems that did arise for patients concerned the ways that complex planning and discharge systems worked and failures in communications and feeling listened to.
It is important to understand how patients (and if appropriate their carers and family members) want to be involved in discussions and decisions about their care and discharge. A clear framework for engagement, starting at the time of admission to hospital or even earlier, must exist. And the advice and support available to patients to ensure their discharge is a comfortable and stress free process must be readily available.
More specifically, patients’ ongoing medical, equipment, therapy and help-at-home needs must be considered and effectively managed (with a plan of action or car plans where appropriate). Properly joined-up and integrated health and social care services are essential to deliver high quality outcomes for patients on their journeys in hospital and after discharge.