Absorptive Capacity and the Uptake of New Discharge Practices in Ontario Hospitals

Abstract

There is a growing realization that there is a relationship between how patients are discharged from hospital and their subsequent readmission, however little research has examined how hospitals discharge patients. “Health literate discharge practices” have been associated with improved patient and health system outcomes. The goals of this study were to examine how Ontario hospitals adopt and use health literate discharge practices, and it asked: what are the absorptive capacity metaroutines that hospitals use in the uptake of health literate discharge practices? Key informant interviews were conducted with 20 participants from 10 hospital sites across Ontario. Our thematic analysis led to the identification of eight metaroutines: allocating resources, building and nurturing external relationships, fostering internal networks, standardizing processes, responding to environmental mandates, engaging patients and families, fostering participative decision making and scanning the external environment. Several barriers to the use of these metaroutines were identified including poor communication and lack of standardized processes. We offer a series of propositions, based on our findings and extant research on organizational learning, to form a new conceptual model regarding the adoption and use of health literate discharge practices in hospitals. The results of this qualitative study offer insights into the metaroutines that hospital managers and leaders use to support the uptake of health literate discharge practices. The findings of this study could be extended to the adoption and use of other evidence-based practices to improve patient care and outcomes.