IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v312y2022ics0277953622006943.html
   My bibliography  Save this article

Discharge readiness as an infrastructure: Negotiating the transfer of care for elderly patients in medical wards

Author

Listed:
  • Skovgaard, Anna Louise
  • Jørgensen, Marianne Johansson
  • Tjørnhøj-Thomsen, Tine
  • Høybye, Mette Terp

Abstract

The discharge from hospital is an essential care transition for elderly people with chronic illness, specifically because the responsibility for treatment and care is transferred between locations and healthcare staff. To optimise the use of healthcare resources in a time of progressively shorter hospital admissions and increasingly streamlined hospital care, discharges are highlighted as important moments to be handled with caution. Yet, discharges are expected to be “early” and “quick” procedures to maintain a flow of patients through the hospital. In this qualitative article, we use ethnographic methods to investigate how this apparent contradiction unfolds in everyday discharge situations through the work of establishing discharge readiness in three medical wards in a middle-sized Danish hospital. We use the lens of infrastructure to help us see how elements like patient screens, screen meetings, clinical (and embodied) signs and community health care criteria are interrelated in the work of establishing discharge readiness of patients. By looking closely into specific discharge situations, we analyse the way care needs are defined and how care work is transferred, and we identify the inherent uncertainties for health care professionals, patients and relatives. We show how clinical signs take precedence over embodied experience, and how complex situations are reduced to workable problems to enable discharge.

Suggested Citation

  • Skovgaard, Anna Louise & Jørgensen, Marianne Johansson & Tjørnhøj-Thomsen, Tine & Høybye, Mette Terp, 2022. "Discharge readiness as an infrastructure: Negotiating the transfer of care for elderly patients in medical wards," Social Science & Medicine, Elsevier, vol. 312(C).
  • Handle: RePEc:eee:socmed:v:312:y:2022:i:c:s0277953622006943
    DOI: 10.1016/j.socscimed.2022.115388
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277953622006943
    Download Restriction: Full text for ScienceDirect subscribers only

    File URL: https://libkey.io/10.1016/j.socscimed.2022.115388?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Jeanette W Kirk & Per Nilsen, 2016. "Implementing evidence‐based practices in an emergency department: contradictions exposed when prioritising a flow culture," Journal of Clinical Nursing, John Wiley & Sons, vol. 25(3-4), pages 555-565, February.
    2. van der Geest, Sjaak & Finkler, Kaja, 2004. "Hospital ethnography: introduction," Social Science & Medicine, Elsevier, vol. 59(10), pages 1995-2001, November.
    3. Bishop, Simon & Waring, Justin, 2019. "From boundary object to boundary subject; the role of the patient in coordination across complex systems of care during hospital discharge," Social Science & Medicine, Elsevier, vol. 235(C), pages 1-1.
    4. Davina Allen & Carl May, 2017. "Organizing Practice and Practicing Organization: An Outline of Translational Mobilization Theory," SAGE Open, , vol. 7(2), pages 21582440177, June.
    5. Allen, Davina, 2009. "From boundary concept to boundary object: The practice and politics of care pathway development," Social Science & Medicine, Elsevier, vol. 69(3), pages 354-361, August.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Poulin, Laura I.L. & Skinner, Mark W. & Fox, Mary T., 2023. "Bed flow priorities and the spatial and temporal dimensions of rural older adult care," Social Science & Medicine, Elsevier, vol. 336(C).
    2. Allen, Davina, 2024. "Why is hospital discharge so difficult? Reconsidering patient trajectories in theory and practice: Insights from an ethnographic study of transitions in hip fracture care," Social Science & Medicine, Elsevier, vol. 347(C).

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Fleming, Mark D. & Safaeinili, Nadia & Knox, Margae & Hernandez, Elizabeth & Brewster, Amanda L., 2023. "Between health care and social services: Boundary objects and cross-sector collaboration," Social Science & Medicine, Elsevier, vol. 320(C).
    2. Wright, Sarah & Porteous, Mary & Stirling, Diane & Young, Oliver & Gourley, Charlie & Hallowell, Nina, 2019. "Negotiating jurisdictional boundaries in response to new genetic possibilities in breast cancer care: The creation of an ‘oncogenetic taskscape’," Social Science & Medicine, Elsevier, vol. 225(C), pages 26-33.
    3. Allen, Davina, 2024. "Why is hospital discharge so difficult? Reconsidering patient trajectories in theory and practice: Insights from an ethnographic study of transitions in hip fracture care," Social Science & Medicine, Elsevier, vol. 347(C).
    4. Biswas, Debashish & Hossin, Raduan & Rahman, Mahbubur & Bardosh, Kevin Louis & Watt, Melissa H. & Zion, Mazharul Islam & Sujon, Hasnat & Rashid, Md Mahbubur & Salimuzzaman, M. & Flora, Meerjady S. & Q, 2020. "An ethnographic exploration of diarrheal disease management in public hospitals in Bangladesh: From problems to solutions," Social Science & Medicine, Elsevier, vol. 260(C).
    5. Battin, Gudrun Songøygard & Romsland, Grace Inga & Christiansen, Bjørg, 2021. "The puzzle of therapeutic emplotment: creating a shared clinical plot through interprofessional interaction in biopsychosocial pain rehabilitation," Social Science & Medicine, Elsevier, vol. 277(C).
    6. Hamdi Lamine & Alessandro Lamberti-Castronuovo & Prinka Singh & Naoufel Chebili & Chekib Zedini & Nebil Achour & Martina Valente & Luca Ragazzoni, 2023. "A Qualitative Study on the Use of the Hospital Safety Index and the Formulation of Recommendations for Future Adaptations," IJERPH, MDPI, vol. 20(6), pages 1-13, March.
    7. Jeanette W Kirk & Ditte M Sivertsen & Janne Petersen & Per Nilsen & Helle V Petersen, 2016. "Barriers and facilitators for implementing a new screening tool in an emergency department: A qualitative study applying the Theoretical Domains Framework," Journal of Clinical Nursing, John Wiley & Sons, vol. 25(19-20), pages 2786-2797, October.
    8. Panter-Brick, Catherine & Eggerman, Mark, 2018. "The field of medical anthropology in Social Science & Medicine," Social Science & Medicine, Elsevier, vol. 196(C), pages 233-239.
    9. Wilfred Dolfsma, 2013. "Government Failure," Books, Edward Elgar Publishing, number 15372.
    10. Topo, Päivi & Iltanen-Tähkävuori, Sonja, 2010. "Scripting patienthood with patient clothing," Social Science & Medicine, Elsevier, vol. 70(11), pages 1682-1689, June.
    11. Cupit, Caroline, 2022. "Public health in the making: Dietary innovators and their on-the-job sociology," Social Science & Medicine, Elsevier, vol. 305(C).
    12. Kapil Babu Dahal, 2022. "Engrained with modernity: commodification, medicalisation, and cross-border medical travel for health care in Nepal," Palgrave Communications, Palgrave Macmillan, vol. 9(1), pages 1-9, December.
    13. Per Magnus Mæhle & Ingrid Kristine Small Hanto & Sigbjørn Smeland, 2020. "Practicing Integrated Care Pathways in Norwegian Hospitals: Coordination through Industrialized Standardization, Value Chains, and Quality Management or an Organizational Equivalent to Improvised Jazz," IJERPH, MDPI, vol. 17(24), pages 1-32, December.
    14. Callum J Gunn & Sevgi E & Teresa Finlay & Lidewij Eva & Teun Zuiderent-Jerak & Tjerk Jan Schuitmaker-Warnaar, 2023. "Co-design and its consequences: developing a shared patient engagement framework in the IMI-PARADIGM project," Science and Public Policy, Oxford University Press, vol. 50(6), pages 1018-1028.
    15. Salhi, Bisan A., 2020. "Who are Clive's friends? Latent sociality in the emergency department," Social Science & Medicine, Elsevier, vol. 245(C).
    16. Oeye, Christine & Bjelland, Anne Karen & Skorpen, Aina, 2007. "Doing participant observation in a psychiatric hospital-- Research ethics resumed," Social Science & Medicine, Elsevier, vol. 65(11), pages 2296-2306, December.
    17. Varley, Emma, 2010. "Targeted doctors, missing patients: Obstetric health services and sectarian conflict in Northern Pakistan," Social Science & Medicine, Elsevier, vol. 70(1), pages 61-70, January.
    18. Evans, Joshua D. & Crooks, Valorie A. & Kingsbury, Paul T., 2009. "Theoretical injections: On the therapeutic aesthetics of medical spaces," Social Science & Medicine, Elsevier, vol. 69(5), pages 716-721, September.
    19. Saario, Sirpa & Hall, Christopher & Peckover, Sue, 2012. "Inter-professional electronic documents and child health: A study of persisting non-electronic communication in the use of electronic documents," Social Science & Medicine, Elsevier, vol. 75(12), pages 2207-2214.
    20. Dimelza Osorio & Esperanza Zuriguel‐Pérez & Soledad Romea‐Lecumberri & Montserrat Tiñena‐Amorós & Montserrat Martínez‐Muñoz & Ángeles Barba‐Flores, 2019. "Selecting and quantifying low‐value nursing care in clinical practice: A questionnaire survey," Journal of Clinical Nursing, John Wiley & Sons, vol. 28(21-22), pages 4053-4061, November.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:312:y:2022:i:c:s0277953622006943. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.