Introduction Increasingly more patients wish to die at home. However it has been identified patients and their carers experience poor hospital discharges as a result of fragmented communication and inadequate co-ordination of services. The anticipated outcome of this audit was to identify areas for improvement for patients and their carers.
Aim The aim of this audit was to highlight both positive and negative aspects of hospital to home discharges and its emotional impact on patients and their carers. While identifying ways in which Hospice at Home (H@H) can improve the transition from hospital to home.
Methods The audit contained a two part questionnaire, completed on 30 referrals to the H@H team. The questionnaire identified areas of particular interest for example district nurse involvement, medications and transport, including patients and carers perspective.
Results Not all patients arrived home therefore did not achieve their PPC. For those that arrived home there were various contributing factors leading to patients encountering a fractured discharge, for example, medication, transport and time of arrival home. Overall, patients and their carers reported negative experiences of their discharges, however despite this carers agreed their decision to bring the patient home was the right one.
Conclusion Significant changes are needed to improve discharges from hospital to home. Services need to be more co-ordinated with an improvement in communication between the acute and primary setting. Delayed or unsupported discharges are memorable and have a long term impact on patients and their carers.
Recommendations A large number of recommendations were derived from the audit incorporating various areas, for instance, education, communication, transport and the extension of services like H@H. The recommendations from the audit can be applied nationally to any discharge regardless of setting.
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