Hospital Discharge

4.
Methods
To best understand the complex factors involved
in participant experiences of discharge, we
adopted a mixed-methods approach (Creswell,
2003; Morgan, 2007). While largely qualitatively
driven, we drew on both qualitative and
quantitative research methods. This approach
was designed to produce: in-depth accounts
of patients’ and carers’ lived experiences; a
rich description of both cultural practices and
processes surrounding discharge: and an analysis
based on statistical survey methods to suggest
causal factors or correlations in patient and carer
experiences of discharge.
Our design was premised on our initial
understanding that hospital discharge is a fluid
process that begins once a patient is admitted,
and carries on throughout their stay in hospital
and beyond. It is a dynamic negotiated process
involving a number of key people – patients,
doctors, other members of the clinical and social
care teams and patients’ family members and/
or carers (formal and informal). We applied
academic rigour with a degree of pragmatism
(what is achievable, practical and ethical),
thinking carefully about how best to capture the
dynamic discharge process (movement over
time) from the perspective of the patients, their
family members (carers) and key staff involved in
the process. To this end we designed a three lens
framework (see Figure 1) to capture experiences
of hospital discharge from different perspectives
in anticipation that these perspectives, when
analysed, would help present an overall picture,
capturing the dynamic nature of hospital
discharge, to inform a broad understanding
of the issues.
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