18 Early supported discharge for older adults admitted to hospital with medical complaints: a qualitative study exploring the views of stakeholders

Abstract

Abstract Background Early Supported Discharge (ESD) is well established as a model of health service delivery for people with stroke. Emerging evidence indicates that ESD reduces length of stay for older medical inpatients. There is a dearth of evidence exploring the views of stakeholders on ESD as a model of care for older medical inpatients. The overall aim of this study is to explore the views and perceptions of older adults, family carers and healthcare professionals on the potential role of ESD for older adults admitted to hospital with medical complaints. Methods We conducted a qualitative interview and focus group study at University Hospital Limerick (UHL) from November 2021 to January 2022. Purposeful sampling was used to recruit older adults and family carers for interview. For Healthcare Professionals (HCPs), snowball purposeful sampling was used for focus groups. Braun and Clarke’s approach to thematic analysis was used. Ethical approval was granted by the HSE Mid-Western Area Regional Ethics Committee in November 2021 (REC Ref. 096/2021). Results Fifteen HCPs took part across three focus groups, with six older adults and two family members participating in one-to-one interviews. Three themes were identified: (1) Pre-ESD experiences of providing and receiving older adult inpatient care, (2) Navigating discharge procedures from acute hospital services and (3) A vision for more integrated model of care and a medical ESD team. Conclusion This qualitative study was the first to explore the views and perceptions of older adults and healthcare professionals on the potential role of ESD for older adults admitted to hospital with medical complaints. The current experiences and barriers to efficient and safe discharge home from hospital were highlighted by stakeholders. The potential role for ESD in this population group was discussed, as well as the key factors to be considered in running an ESD service for medical older adults.