Table 3 Workshop thematic analysis
Issue/ solution raised in: | |||||
|---|---|---|---|---|---|
Theoretical theme | Emergent theme | Issue | Solutions | Patient workshop | Staff workshop |
Organisation | A good discharge | Follow up appointment letters are too generic and sometimes arrive too late | Appointments provided at discharge, with written explanation of purpose. Translators provided when first language other than English. | ✔ | ✔ |
Care across the continuum | Poor continuity of care – hospital does not communicate with GP or external health providers following discharge | Phone call to GP to go over care plan, identify follow up appointments required with GP and with hospital providers. | ✔ | ||
Inconsistent messages about management of condition across the care continuum | Shared management of patient using guidelines developed in partnership. | ✔ | |||
Outpatient hospital appointments are often too short to allow patients time to ask questions they need to manage their health | Shared medical record (e-health record) | ✔ | ✔ | ||
Follow-up outpatient appointments long enough for patients to ask questions | ✔ | ||||
Need method to identify patients who don’t have a regular GP, or a good relationship with GP | ✔ | ✔ | |||
Patient – Provider interface | Good quality communication during hospital stay | English as a second language not consistently managed well – harder to check for understanding | Request carer/ support person attend appointments and discharge. | ✔ | ✔ |
Dedicated time with interpreter to go over key discharge points. | ✔ | ||||
Follow up group therapy provided in different languages (where possible) with other patients who speak same language. | ✔ | ✔ | |||
Too much information provided during hospital stay | Use teach back to check for understanding. | ✔ | |||
No one discusses with patient what format they want to receive information in. | Use teach back to check for understanding. Use different methods for teaching (including brochures, videos pictures, demonstration, verbal instruction). | ✔ | |||
Health professionals do not check if a patient understands them. | Teach back become part of organisation wide teaching and training for all clinicians. | ✔ | |||
Health professionals use medical terminology when explaining information to patients | Teach back become part of organisation wide teaching and training for all clinicians. | ✔ | |||
A good discharge | Information overload at point of discharge | Use teach back to check for understanding. | ✔ | ||
Develop a good care plan that patient is involved in with that has good information sources. This might include links to reliable internet sources. You then need get him to a point where you are certain he understands it. | ✔ | ✔ | |||
Discharge summary explained directly to the patient with a copy provided for them to keep for themselves. | ✔ | ✔ | |||
Social support for health | Patients may not be able to take in everything they are told – a second pair of ears may be helpful | Request carer/ support person attend appointments and discharge. | ✔ | ||
Patient’s need social support for motivation – group therapy with cultural and language groups | Follow up group therapy provided in different languages (where possible) and/ or with other patients from same cultural group. | ✔ | ✔ | ||
Need to identify patients who are socially vulnerable | Identify patients without support networks and link them in to social | ✔ | ✔ | ||
Patient self-care | Accessing quality information when home | Both clinicians and patients may rely on the internet for information that is not necessarily reliable | Hospital provide links to reliable sources of information on the web on its website. | ✔ | |
Links to reliable information provided as part of patient care plan. | ✔ | ||||
Clinicians not always aware of information available in different languages | Hospital communications office provide information in different languages for different presentations | ✔ | |||