TY - JOUR T1 - Are patients discharged with care? A qualitative study of perceptions and experiences of patients, family members and care providers JF - BMJ Quality & Safety JO - BMJ Qual Saf SP - i39 LP - i49 DO - 10.1136/bmjqs-2012-001165 VL - 21 IS - Suppl 1 AU - Gijs Hesselink AU - Maria Flink AU - Mariann Olsson AU - Paul Barach AU - Ewa Dudzik-Urbaniak AU - Carola Orrego AU - Giulio Toccafondi AU - Cor Kalkman AU - Julie K Johnson AU - Lisette Schoonhoven AU - Myrra Vernooij-Dassen AU - Hub Wollersheim AU - on behalf of the European HANDOVER Research Collaborative Y1 - 2012/12/01 UR - http://qualitysafety.bmj.com/content/21/Suppl_1/i39.abstract N2 - Background Advocates for quality and safety have called for healthcare that is patient-centred and decision-making that involves patients. Objective The aim of the paper is to explore the barriers and facilitators to patient-centred care in the hospital discharge process. Methods A qualitative study using purposive sampling of 192 individual interviews and 26 focus group interviews was conducted in five European Union countries with patients and/or family members, hospital physicians and nurses, and community general practitioners and nurses. A modified Grounded Theory approach was used to analyse the data. Results The barriers and facilitators were classified into 15 categories from which four themes emerged: (1) healthcare providers do not sufficiently prioritise discharge consultations with patients and family members due to time restraints and competing care obligations; (2) discharge communication varied from instructing patients and family members to shared decision-making; (3) patients often feel unprepared for discharge, and postdischarge care is not tailored to individual patient needs and preferences; and (4) pressure on available hospital beds and community resources affect the discharge process. Conclusions Our findings suggest that involvement of patients and families in the preparations for discharge is determined by the extent to which care providers are willing and able to accommodate patients’ and families’ capabilities, needs and preferences. Future interventions should be directed at healthcare providers’ attitudes and their organisation's leadership, with a focus on improving communication among care providers, patients and families, and between hospital and community care providers. ER -