Comparative study of nurses’ perception of barriers and facilitators for care coordination

Abstract

Abstract Background The hospital discharge process of older adults with complex health and social care needs requires coordination between multiple care providers. Providing insight to the care coordination from healthcare professionals' views is crucial to show what efforts are needed to manage the discharge process, and to identify strengths and weaknesses of the care systems in which they operate. The aim of this study was to examine nurses' perceptions on barriers and facilitators of good care coordination for older patients with complex health and social care needs being discharged from hospital in Copenhagen (DK) and Stockholm (SE). Methods Semi-structured interviews were conducted with 27 nurses involved in the coordination of the discharge process at hospitals and home healthcare services (Copenhagen n = 11, Stockholm n = 16). The interview guide included questions on the nurses' contributions, responsibilities and influence on the discharge process. They were also asked about collaboration and interaction with other professionals involved in the process. The data was analysed with a thematic content analysis approach. Results Main themes were communication ways, organisational structures and supplementary actions by staff. Preliminary findings include differences in the organisational structure of the two care systems in relation to integration between different actors and differences in how they consider access to patient information, which influences the coordination. There also seem to be discrepancies in care policies and outlined staff responsibilities compared to the actually work undertaken by the nurses in both care systems. Conclusions There are lessons to be learned from both care systems. The written e-communication between hospitals and home health care runs smoothly in Stockholm, whereas it is perceived as a one-way communication in Copenhagen. In Copenhagen there is more sector-overlapping work which might secure a safer transition from hospital to home. Key messages The written e-communication between hospitals and home health care runs smoothly in Stockholm, whereas it is perceived as a one-way communication in Copenhagen. In Copenhagen there is more sector-overlapping work than in Stockholm which might secure a safer transition from hospital to home.