Patient Discharge from acute medicine: Observation of practice
Research type
Research Study
Full title
Patient discharge from Acute Medicine: Observation of discharge practice on ward rounds on an acute medicine unit
IRAS ID
191480
Contact name
Liz Deutsch
Contact email
Duration of Study in the UK
0 years, 4 months, 1 days
Research summary
Summary of Background:
Acute Medicine Units (AMUs) assess, admit and discharge patients who attend hospitals as an emergency with medical conditions. AMUs work with Emergency Departments (EDs) having joint responsibility for managing patient throughput. EDs and AMUs are incredibly busy places; in 2012/13, 18.3 million patients were admitted to hospital via an ED. Having efficient processes in place to manage patient discharge from hospital is essential. However, this does not always happen, as recent national press reports (September 2015) of hospitals being placed in 'special measures' owing to lack of bed capacity graphically illustrate.Integral to discharging patients safely is risk assessment (i.e., deciding whether a patient can be safely sent home or whether they need to be transferred elsewhere). Currently, there is no standard approach to assessing patients' readiness for discharge from EDs and AMUs. A literature search revealed twenty-seven discharge policies nationally, inconsistent staff compliance with risk assessment procedures and limited patient engagement.
The aim of this study is to provide in depth understanding of the process of discharging patients from an AMU.
The overall research design is an Explanatory Case Study (Yin, 1994), an approach widely used to study 'real-world' issues in context, collecting multiple data sources. This application relates to one part of the Case Study, namely; observation of staff and patients on ward rounds - where discharge planning activities take place.
Data collection will take place in one large AMU in the West Midlands, through non- participant observation of the AMU ward round team (a multi-professional group of staff) and patients being reviewed. Audio recording of conversations relating to patient discharge and subsequent analysis of the related discharge documentation will be undertaken.
Data will be analysed using the Framework approach (Ritchie & Spencer, 1984), to identify key issues.
The study's intended outcome is to improve the discharge process, in emergency care.
REC name
North East - Tyne & Wear South Research Ethics Committee
REC reference
16/NE/0056
Date of REC Opinion
16 Feb 2016
REC opinion
Favourable Opinion