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Relational practice as they key to ensuring quality care for frail older people
 — discharge planning as a case example
Author(s)Sion Williams, Mike Nolan, John Keady
Journal titleQuality in Ageing, vol 10, issue 3, September 2009
Pagespp 44-55
KeywordsDischarge [hospitals] ; Planning [admin] ; Management [care] ; Quality.
AnnotationDischarging frail older people from acute hospital settings has been an issue of concern for over 40 years and recent studies suggest that enduring problems remain. This paper explores the experiences of discharge from three different units: an acute surgical ward, an acute medical ward and a specialist ward for older people. Based on extensive data from interviews with older people, their family carers and ward-based staff, a grounded theory of the discharge experience is presented. This suggests that the quality of discharge hinges largely on whether the focus of efforts is on 'pace' (the desire to discharge older people as rapidly as possible) or 'complexity' (where due account is taken of the complex interaction of medical and wider social issues). When pace is the focus, 'pushing' and 'fixing' are the main processes driving discharge. However, when attention is given to complexity, far more subtle processes of 'informing' and 'brokering' are in evidence. These latter processes are conceived of as forms of 'relational practice' and it is argued that such practices lie at the heart of high quality care for older people. (KJ/RH).
Accession NumberCPA-100106212 A
ClassmarkLD:QKJ: QA6: QA: 59

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