The Barriers To Patient-Centred Care Discussion

Healthcare service providers are increasingly gaining interest in the patient-specific care continuum. The focus on improving patient experiences has attracted attention from policymakers and health care service providers advocating for patient-centered care. However, discharge process factors may stand out as barriers to patient-centered care. This paper details the challenges to patient-centered care linked to the patient discharge process. The Barriers To Patient-Centred Care Discussion

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The patient discharge process significantly affects the quality of care. The global healthcare system has witnessed a rise in healthcare demand, proportionally increasing the need for health care practitioners marked by the disproportionately lower nurse population (Kiwanuka et al., 2019). In light, nurses struggle with the patient workload due to competing care obligations derail discharge planning discussions. The nursing shortage affects the quality-of-care delivery by reducing the nurse-to-patient ratio and deteriorating the care outcome (Ghafoor et al., 2021). The overwhelming patient care needs to decrease the attention to the discharge process and planning discussions and affect the follow-up care. According to Bahr and Weiss (2019), discharge planning promotes care continuity; hence should be conducted based on a specific framework that guarantees a smooth transition from hospital to home care. On the same note, Balasundaram et al. (2022) noted that smooth and efficient discharge reduces stress and anxiety in patients, family, clinical team and community service. The discharge planning process involves clinicians, nurses, the patient and family. Break in the communication channel can impair priority discussions on discharge and post-discharge care and hinder patient-centred care The Barriers To Patient-Cantered Care Discussion.

Communication is an important tool in decision-making. Competitive care demands can break the discharge communication structure hampering decision-making and sharing of  patient’s perspective in discharge processing. One-sided communication flow may be experienced due to lack of patient engagement time and feedback. Weetman et al. (2018) emphasized the influence of the patient’s choice in an effective and successful discharge process. Lack of communication between the care provider and the patient during the discharge process fails to capture the patient’s concerns curtailing patient-cantered care delivery.

The breakdown between physician and patient communication can result in unplanned and unindividualized post-discharge care. The discharge decision-making process should be based on the outcome of the patient and clinician discharge discussion. However, patient and organizational pressures can also alter the discharge process (Lehn et al., 2019)The Barriers To Patient-Cantered Care Discussion. For instance, the discharge decision can be triggered by the available beds in the healthcare facility. The shortage in the facility’s patient-holding capacity prompts immediate discharge initiation, which may fail to embrace the standard discharge guidelines. The management acknowledges the deficit in the patient outcome and the need for further stay in the hospital. However, the overwhelming demand for clinical attention forces the patients into early and unplanned discharges that fail to acknowledge the care demands.

In summary, patient-centred care is an important aspect of the care delivery continuum. However, the discharge process can impair patient-centered care from the increased patient load, deterioration of discharge communication, patient unpreparedness and organizational pressure. The strain on the available nurses from the competing care obligations can also affect discharge decision-making and patient preparedness for discharge The Barriers To Patient-Cantered Care Discussion.

References

Balasundaram, M., Porter, M., Miller, S., Sivakumar, D., Fleming, A., McCallie, K., & Harris-Haman, P. A. (2022). Increasing parent satisfaction with discharge planning: An improvement project using Technology in a Level 3 NICU. Advances in Neonatal Care, 22(2), 108-118. https://doi.org/10.1097/ANC.0000000000000841

Ghafoor, Y., Yaqoob, M. A., Bilal, M. A., & Ghafoor, M. S. (2021). Impact of nurse shortage on patient care. Saudi J Nurs Heal Care, 4(4), 114-9.  http://doi.org/10.36348/sjnhc.2021.v04i04.003

Kiwanuka, F., Shayan, S. J., & Tolulope, A. A. (2019). Barriers to patient and family‐centred care in adult intensive care units: A systematic review. Nursing open, 6(3), 676-684. https://doi.org/10.1002/nop2.253

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Lehn, S. F., Zwisler, A. D., Pedersen, S. G. H., Gjørup, T., & Thygesen, L. C. (2019). Patient-specific versus organizational barriers to program adherence: a multivariate analysis. International Journal of Integrated Care, 19(1). http://doi.org/10.5334/ijic.4212

Weetman, K., Dale, J., Scott, E., & Schnurr, S. (2021). Discharge communication study: a realist evaluation of discharge communication experiences of patients, general practitioners and hospital practitioners, alongside a corresponding discharge letter sample. BMJ open, 11(7), e045465. https://doi.org/10.1186/s12913-019-4612-1 The Barriers To Patient-Cantered Care Discussion