Background
Discharge planning is important to bridge the gap between hospital and home. Many patients with chronic heart failure are often fragile elderly with co-morbidities and functional decline due to increased symptom burden. A structured Gothenburg person-centred care (GPCC) approach may promote better discharge-planning.
Aims
To evaluate whether proactive care-planning based on the GPCC model leads to improved efficiency in discharge procedures compared with usual care in patients hospitalized for worsening chronic heart failure.
Methods
In a controlled before-and-after design, patients hospitalized for worsening chronic heart failure were assigned to either a usual care group or a GPCC intervention group. The patients’ social situation, their discharge destination and the number of days until the discharge were recorded. The time interval (in days) between notification and start of coordination of care was recorded.
Results
In total, 248 patients were included, 123 in the usual care group and 125 in the GPCC intervention. During hospitalization, notifications to the community home help service and/or round-the-clock home nursing care services were more frequent in the GPCC-group (33.8%) compared with patients in the usual care group (12.1%). A confirmed discharge planning conference started within the first five days in the GPCC group whereas the usual care group ranged from one to 28 days. Compared with the usual care group, the GPCC group had fewer days in hospital (11 versus 35) ready for discharge.
Conclusion
Person-centred care improves discharge processes because patients are viewed as competent to be involved in planning their subsequent care.
This study was published in an article in European Journal of Cardiovascular Nursing entitled Person-centred care - An approach. Link to the full article.
Contact
Kerstin Ulin, PhD, Reg Nurse, University of Gothenburg Centre for Person-centred Care, Sahlgrenska Academy
Telephone: +46-(0)31-786 2313
Email: kerstin.ulin@gu.se