What influences preparations of discharge documentation at patient discharge? An interview study with hospital health professionals based on the theoretical domains framework

ObjectivesPoor quality handover instructions prepared by hospital staff have been identified as a key threat to safe discharges. To optimise patient safety, it is important to identify and understand the influences on how discharge documentation is prepared by hospital staff. The aim of this study w...

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Veröffentlicht in:BMJ open Jg. 15; H. 6; S. e090753
Hauptverfasser: Markiewicz, Ola Malgorzata, Menon, Aarya, Acharya, Amish, D’Lima, Danielle, Lorencatto, Fabiana, Darzi, Ara, Judah, G
Format: Journal Article
Sprache:Englisch
Veröffentlicht: England British Medical Journal Publishing Group 16.06.2025
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ISSN:2044-6055, 2044-6055
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Abstract ObjectivesPoor quality handover instructions prepared by hospital staff have been identified as a key threat to safe discharges. To optimise patient safety, it is important to identify and understand the influences on how discharge documentation is prepared by hospital staff. The aim of this study was to systematically identify and explore important barriers and enablers to the preparation of high-quality discharge documentation by healthcare professionals (HCPs) for primary care teams at patient discharge.Setting and participantsHCPs from different staff groups (doctors, nurses, pharmacists, occupational and physiotherapists) participated in online interviews.DesignSemistructured interviews informed by the theoretical domains framework (TDF), to identify key influences on the preparation of discharge documentation. Anonymised transcripts were analysed thematically using a combined inductive-deductive approach. Themes were framed as influences on the preparation of discharge documentation. The likely importance of influences was decided through iterative team discussions structured on predetermined criteria. Criteria included whether the influence was an existing enabler, whether beliefs about the influences were expressed voluntarily and how often they were mentioned.Results12 HCPs were interviewed (5 junior doctors, 1 advanced nurse practitioner, 2 nurses, 1 occupational therapist, 1 physiotherapist and 2 pharmacists). Of 44 influences identified, 10 were deemed most important in the preparation of discharge documentation, spread across five TDF domains: knowledge (eg, lack of awareness of guidelines), skills (experience of hospital staff), social and professional role and identity (effective team communication), environmental context and resources (eg, software limitations) and social influences (eg, lack of feedback).ConclusionsThis study identified 10 important influences on how discharge documentation is prepared by hospital staff. These influences are potential targets for subsequent interventions to improve the quality of discharge documentation and patient safety during discharge.
AbstractList ObjectivesPoor quality handover instructions prepared by hospital staff have been identified as a key threat to safe discharges. To optimise patient safety, it is important to identify and understand the influences on how discharge documentation is prepared by hospital staff. The aim of this study was to systematically identify and explore important barriers and enablers to the preparation of high-quality discharge documentation by healthcare professionals (HCPs) for primary care teams at patient discharge.Setting and participantsHCPs from different staff groups (doctors, nurses, pharmacists, occupational and physiotherapists) participated in online interviews.DesignSemistructured interviews informed by the theoretical domains framework (TDF), to identify key influences on the preparation of discharge documentation. Anonymised transcripts were analysed thematically using a combined inductive-deductive approach. Themes were framed as influences on the preparation of discharge documentation. The likely importance of influences was decided through iterative team discussions structured on predetermined criteria. Criteria included whether the influence was an existing enabler, whether beliefs about the influences were expressed voluntarily and how often they were mentioned.Results12 HCPs were interviewed (5 junior doctors, 1 advanced nurse practitioner, 2 nurses, 1 occupational therapist, 1 physiotherapist and 2 pharmacists). Of 44 influences identified, 10 were deemed most important in the preparation of discharge documentation, spread across five TDF domains: knowledge (eg, lack of awareness of guidelines), skills (experience of hospital staff), social and professional role and identity (effective team communication), environmental context and resources (eg, software limitations) and social influences (eg, lack of feedback).ConclusionsThis study identified 10 important influences on how discharge documentation is prepared by hospital staff. These influences are potential targets for subsequent interventions to improve the quality of discharge documentation and patient safety during discharge.
Poor quality handover instructions prepared by hospital staff have been identified as a key threat to safe discharges. To optimise patient safety, it is important to identify and understand the influences on how discharge documentation is prepared by hospital staff. The aim of this study was to systematically identify and explore important barriers and enablers to the preparation of high-quality discharge documentation by healthcare professionals (HCPs) for primary care teams at patient discharge.OBJECTIVESPoor quality handover instructions prepared by hospital staff have been identified as a key threat to safe discharges. To optimise patient safety, it is important to identify and understand the influences on how discharge documentation is prepared by hospital staff. The aim of this study was to systematically identify and explore important barriers and enablers to the preparation of high-quality discharge documentation by healthcare professionals (HCPs) for primary care teams at patient discharge.HCPs from different staff groups (doctors, nurses, pharmacists, occupational and physiotherapists) participated in online interviews.SETTING AND PARTICIPANTSHCPs from different staff groups (doctors, nurses, pharmacists, occupational and physiotherapists) participated in online interviews.Semistructured interviews informed by the theoretical domains framework (TDF), to identify key influences on the preparation of discharge documentation. Anonymised transcripts were analysed thematically using a combined inductive-deductive approach. Themes were framed as influences on the preparation of discharge documentation. The likely importance of influences was decided through iterative team discussions structured on predetermined criteria. Criteria included whether the influence was an existing enabler, whether beliefs about the influences were expressed voluntarily and how often they were mentioned.DESIGNSemistructured interviews informed by the theoretical domains framework (TDF), to identify key influences on the preparation of discharge documentation. Anonymised transcripts were analysed thematically using a combined inductive-deductive approach. Themes were framed as influences on the preparation of discharge documentation. The likely importance of influences was decided through iterative team discussions structured on predetermined criteria. Criteria included whether the influence was an existing enabler, whether beliefs about the influences were expressed voluntarily and how often they were mentioned.12 HCPs were interviewed (5 junior doctors, 1 advanced nurse practitioner, 2 nurses, 1 occupational therapist, 1 physiotherapist and 2 pharmacists). Of 44 influences identified, 10 were deemed most important in the preparation of discharge documentation, spread across five TDF domains: knowledge (eg, lack of awareness of guidelines), skills (experience of hospital staff), social and professional role and identity (effective team communication), environmental context and resources (eg, software limitations) and social influences (eg, lack of feedback).RESULTS12 HCPs were interviewed (5 junior doctors, 1 advanced nurse practitioner, 2 nurses, 1 occupational therapist, 1 physiotherapist and 2 pharmacists). Of 44 influences identified, 10 were deemed most important in the preparation of discharge documentation, spread across five TDF domains: knowledge (eg, lack of awareness of guidelines), skills (experience of hospital staff), social and professional role and identity (effective team communication), environmental context and resources (eg, software limitations) and social influences (eg, lack of feedback).This study identified 10 important influences on how discharge documentation is prepared by hospital staff. These influences are potential targets for subsequent interventions to improve the quality of discharge documentation and patient safety during discharge.CONCLUSIONSThis study identified 10 important influences on how discharge documentation is prepared by hospital staff. These influences are potential targets for subsequent interventions to improve the quality of discharge documentation and patient safety during discharge.
Objectives Poor quality handover instructions prepared by hospital staff have been identified as a key threat to safe discharges. To optimise patient safety, it is important to identify and understand the influences on how discharge documentation is prepared by hospital staff. The aim of this study was to systematically identify and explore important barriers and enablers to the preparation of high-quality discharge documentation by healthcare professionals (HCPs) for primary care teams at patient discharge.Setting and participants HCPs from different staff groups (doctors, nurses, pharmacists, occupational and physiotherapists) participated in online interviews.Design Semistructured interviews informed by the theoretical domains framework (TDF), to identify key influences on the preparation of discharge documentation. Anonymised transcripts were analysed thematically using a combined inductive-deductive approach. Themes were framed as influences on the preparation of discharge documentation. The likely importance of influences was decided through iterative team discussions structured on predetermined criteria. Criteria included whether the influence was an existing enabler, whether beliefs about the influences were expressed voluntarily and how often they were mentioned.Results 12 HCPs were interviewed (5 junior doctors, 1 advanced nurse practitioner, 2 nurses, 1 occupational therapist, 1 physiotherapist and 2 pharmacists). Of 44 influences identified, 10 were deemed most important in the preparation of discharge documentation, spread across five TDF domains: knowledge (eg, lack of awareness of guidelines), skills (experience of hospital staff), social and professional role and identity (effective team communication), environmental context and resources (eg, software limitations) and social influences (eg, lack of feedback).Conclusions This study identified 10 important influences on how discharge documentation is prepared by hospital staff. These influences are potential targets for subsequent interventions to improve the quality of discharge documentation and patient safety during discharge.
Poor quality handover instructions prepared by hospital staff have been identified as a key threat to safe discharges. To optimise patient safety, it is important to identify and understand the influences on how discharge documentation is prepared by hospital staff. The aim of this study was to systematically identify and explore important barriers and enablers to the preparation of high-quality discharge documentation by healthcare professionals (HCPs) for primary care teams at patient discharge. HCPs from different staff groups (doctors, nurses, pharmacists, occupational and physiotherapists) participated in online interviews. Semistructured interviews informed by the theoretical domains framework (TDF), to identify key influences on the preparation of discharge documentation. Anonymised transcripts were analysed thematically using a combined inductive-deductive approach. Themes were framed as influences on the preparation of discharge documentation. The likely importance of influences was decided through iterative team discussions structured on predetermined criteria. Criteria included whether the influence was an existing enabler, whether beliefs about the influences were expressed voluntarily and how often they were mentioned. 12 HCPs were interviewed (5 junior doctors, 1 advanced nurse practitioner, 2 nurses, 1 occupational therapist, 1 physiotherapist and 2 pharmacists). Of 44 influences identified, 10 were deemed most important in the preparation of discharge documentation, spread across five TDF domains: knowledge (eg, lack of awareness of guidelines), skills (experience of hospital staff), social and professional role and identity (effective team communication), environmental context and resources (eg, software limitations) and social influences (eg, lack of feedback). This study identified 10 important influences on how discharge documentation is prepared by hospital staff. These influences are potential targets for subsequent interventions to improve the quality of discharge documentation and patient safety during discharge.
Author Menon, Aarya
Judah, G
Markiewicz, Ola Malgorzata
D’Lima, Danielle
Acharya, Amish
Darzi, Ara
Lorencatto, Fabiana
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  organization: Department of Surgery & Cancer, Imperial College London, London, UK
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  givenname: Aarya
  surname: Menon
  fullname: Menon, Aarya
  organization: Department of Surgery & Cancer, Imperial College London, London, UK
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  organization: Centre for Health Policy, Imperial College London Institute of Global Health Innovation, London, UK
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  surname: D’Lima
  fullname: D’Lima, Danielle
  organization: Department of Applied Research London, University College London, London, UK
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  orcidid: 0000-0003-3322-9760
  surname: Judah
  fullname: Judah, G
  organization: Imperial College London, London, UK
BackLink https://www.ncbi.nlm.nih.gov/pubmed/40523784$$D View this record in MEDLINE/PubMed
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Issue 6
Keywords Health policy
Hospitals
Primary Care
Hospital to Home Transition
Quality in health care
Language English
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Snippet ObjectivesPoor quality handover instructions prepared by hospital staff have been identified as a key threat to safe discharges. To optimise patient safety, it...
Poor quality handover instructions prepared by hospital staff have been identified as a key threat to safe discharges. To optimise patient safety, it is...
Objectives Poor quality handover instructions prepared by hospital staff have been identified as a key threat to safe discharges. To optimise patient safety,...
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SubjectTerms Attitude of Health Personnel
Behavior
Data collection
Documentation
Documentation - standards
Female
General practice / Family practice
Health policy
Hospital to Home Transition
Hospitals
Humans
Interviews
Interviews as Topic
Male
Medical referrals
Medical research
Nurses
Patient Discharge - standards
Patient Handoff - standards
Patient Safety
Pharmacists
Physicians
Primary Care
Professional relationships
Professionals
Qualitative Research
Quality in health care
Science
Teams
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Title What influences preparations of discharge documentation at patient discharge? An interview study with hospital health professionals based on the theoretical domains framework
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