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Original research
Measuring discharge quality based on elderly patients’ experiences with discharge conversation: a cross-sectional study
  1. Ranveig Marie Boge1,2,
  2. Arvid Steinar Haugen3,
  3. Roy Miodini Nilsen4,5,
  4. Frøydis Bruvik6,7,
  5. Stig Harthug4,8
  1. 1Department of Clinicial sciences, University of Bergen, Bergen, Norway
  2. 2Department of Medicine, Haukeland University Hospital, Bergen, Norway
  3. 3Department of Anaesthesia and Intensive Care, Haukeland University Hospital, Bergen, Norway
  4. 4Department of Research and Development, Haukeland University Hospital, Bergen, Norway
  5. 5Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Hordaland, Norway
  6. 6Haraldsplass Deaconess Hospital, Bergen, Norway
  7. 7Department of Global Public Health and Primary Care, University of Bergen, Bergen, Hordaland, Norway
  8. 8Department of Clinical Research, University of Bergen, Bergen, Hordaland, Norway
  1. Correspondence to Ranveig Marie Boge; ranveig.boge{at}gmail.com

Abstract

Background Discharge conversation is an essential part of preparing patients for the period after hospitalisation. Successful communication during such conversations is associated with improved health outcomes for patients.

Objective To investigate the association between discharge conversation and discharge quality assessed by measuring elderly patients’ experiences.

Methods In this cross-sectional study, we surveyed all patients ≥65 years who had been discharged from two medical units in two hospitals in Western Norway 30 days prior. We measured patient experiences using two previously validated instruments: The Discharge Care Experiences Survey Modified (DICARES-M) and The Nordic Patient Experiences Questionnaire (NORPEQ). We examined differences in characteristics between patients who reported having a discharge conversation with those who did not, and used regression analyses to examine the associations of the DICARES-M and NORPEQ with the usefulness of discharge conversation.

Results Of the 1418 invited patients, 487 (34%) returned the survey. Their mean age was 78.5 years (SD=8.3) and 52% were women. The total sample mean scores for the DICARES-M and NORPEQ were 3.9 (SD=0.7, range: 1.5–5.0) and 4.0 (SD=0.7, range: 2.2–5.0), respectively. Higher DICARES-M and NORPEQ scores were found for patients who reported having a discharge conversation (74%) compared with those who did not (15%), or were unsure (11%) whether they had a conversation (p<0.001). Patients who considered the conversation more useful had significantly higher scores on both the DICARES-M and NORPEQ (p<0.001).

Conclusions Reported discharge conversation at the hospital was correlated with positive patient experiences measurements indicating the increased quality of hospital discharge care. The reported usefulness of the conversation had a significant association with discharge care quality.

  • patient discharge
  • health services research
  • quality measurement

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjoq-2019-000728

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    Footnotes

    • Twitter @HaugenArvid

    • Contributors RMB and SH: designed and planned the study; performed quality assurance of the data. ASH and FB: participated in planning the study; contributed to the interpretation of the data. RMB: obtained the data; prepared the first draft of the manuscript.RMB, RMN and SH: contributed to the analysis and interpretation of the data. SH, ASH, RMN and FB: provided critical revisions. All authors read and approved the final manuscript.

    • Funding This research was supported by research grants from the Western Norway Regional Health Authority (project number HV-911936), and a local Health Research Scholarship. ASH was funded by a postdoctoral research grant (grant number: HV1172) from the Western Norway Regional Health Authority’s Patient Safety Program. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Ethics approval Western Norway Regional Committee for Medical and Health Research Ethics (Ref.: 2015/329).

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information. All data generated or analysed during this study are included in the published article [and its supplementary information files].