Key result
Early supported discharge in COPD is associated with feelings of premature discharge and home-transition difficulties.
Why the study?
Patients' views of an early supported discharge service for COPD were explored to understand their experiences and perceptions of this care model.
Early supported discharge for COPD may not promote an equal partnership between patient and healthcare in practice, as patients often feel unprepared for discharge and struggle with the transition home.
Patients' views on early COPD discharge support may refine service delivery; leaves open effects on readmission or satisfaction.
OBJECTIVE: To explore patients' views of an early supported discharge service for chronic obstructive pulmonary disease (COPD). INTERVENTION: Early supported discharge service (EDS) with discharge at 3.5 days (average length of stay for COPD at the time was 9.5 days). After discharge, patients were visited at home daily for 3 days by a nurse from the early discharge service and then, as required, up to 2 weeks. PARTICIPANTS: Purposive, maximum variation sample of 23 mainly older, retired patients admitted to hospital with an acute exacerbation of COPD in 2005. 14 patients listed as receiving EDS, and 9 listed as refusing EDS. DESIGN: Qualitative analysis of audiotaped, semistructured, face-to-face interviews. Setting Economically deprived inner-city borough in England. Results (1) Negotiation and consent. Patients had little recall of being approached to join the scheme. They often felt they had been discharged from hospital before they were ready. They were often unable or unwilling to negotiate timing of discharge with hospital staff. (2) Process of discharge from hospital. Patients experienced difficulties with transport home and supplies of medication. (3) Life at home after a hospital admission. Resuming life at home after an admission for an acute exacerbation for COPD was difficult. Not all patients found the home nursing component of the service helpful. CONCLUSIONS: Early supported discharge with domiciliary care is a model that ought to promote a more equal partnership between patient and healthcare, but this did not appear to be the case in practice.
No takes yet. Share an insight, caveat, or question.
Clarke et al. (2010) studied Chronic obstructive pulmonary disease (COPD) (n=23). Early supported discharge service (EDS) vs. Refusing EDS was evaluated on Patients' views of an early supported discharge service. Qualitative interviews of 23 COPD patients revealed that early supported discharge often led to feelings of premature discharge and difficulties with transport, medication, and resuming life at home.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: