Abstract
Background:One of the main factors relating to quality of hospitals is effective discharge planning. Discharge planning promotes the quality of inpatient care and reduces unplanned hospital readmission. The current study investigated the challenges of discharge planning observed in the health system of Iran.Methods:This qualitative research was conducted using a thematic and framework analyses to identify the challenges under each themes defined by the World Health Organization (WHO), to understand barriers in developing an effective discharge planning system in Iran health system. The data was collected from detailed semi-structured interviews and sessions of focus group discussions. This study involved 51 participants including health policy makers, hospital and health managers, faculty members, nurses, practitioners, community medicine specialists and other professionals of the Ministry of Health and Medical Education (MOHME). To reduce the bias and to increase the credibility of the study, evaluation criteria from Lincoln and Guba were used. All interviews and FGDs were recorded and transcribed, then analyzed by the software MAXQDA-11 and also manually.Results:According to the WHO health systems framework, challenges of effective hospital discharge planning were divided into six areas, leadership/governance, service delivery, information, financing, health workforce, and medical production(themes), in which there were 5,3,2,2,3,1 subthemes respectively.Conclusion:It is evident from the findings of this study that changes in the perspective of policy makers, health staff and managers, strengthening of systematic approach, and establishment of required infrastructures are essential for successful implementation of effective discharge planning in health systems in Iran.
Highlights
One of the main factors relating to quality of hospitals is effective discharge planning
According to the World Health Organization (WHO) health systems framework, challenges of effective hospital discharge planning were divided into six areas, leadership/governance, service delivery, information, financing, health workforce, and medical production(themes), in which there were 5,3,2,2,3,1 subthemes respectively
It is evident from the findings of this study that changes in the perspective of policy makers, health staff and managers, strengthening of systematic approach, and establishment of required infrastructures are essential for successful implementation of effective discharge planning in health systems in Iran
Summary
One of the main factors relating to quality of hospitals is effective discharge planning. Discharge planning promotes the quality of inpatient care and reduces unplanned hospital readmission. Discharge planning is a main concept for quality patient care and sustainability of health system. Studies have shown implementing discharge planning could lead to decreasing the length of stay (LOS) and readmission, lowering costs, ensuring the continuity of care in the community, improving patient’s mental health, patient satisfaction with members of carer team, improving disease outcomes and a safer patient transition to home (Shepperd et al, 2013).Discharge planning improves the quality of life in patients and their families (Jackson, 1994). Discharge planning is vital in a health system and lack of effective discharge planning is the main challenge in promoting the quality of care (RB & AJ, 2004). Gaps in discharge planning can lead to unnecessary readmissions which can be expensive and life www.ccsenet.org/gjhs
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