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Postgraduate medicine · Mar 2024
Thrown in at the deep end: a qualitative study with physicians on the purpose and challenges of discharge interviews.
- Lorena Morschek, Jobst-Hendrik Schultz, Ricarda Wigbels, Nadja Gebhardt, Cassandra Derreza-Greeven, Hans-Christoph Friederich, Alexandra Noll, Inga Unger, Christoph Nikendei, and Till Johannes Bugaj.
- Department of General Internal Medicine and Psychosomatics, Heidelberg University Hospital, Heidelberg, Germany.
- Postgrad Med. 2024 Mar 1; 136 (2): 180188180-188.
ObjectivesAgainst the backdrop of poor discharge communication in hospitals, this study explores the purpose of discharge interviews from the physicians' perspective and the challenges they are confronted with. Discharge interviews are legally required in Germany as part of the discharge management. Led by the ward physician, the discharge interview should summarize relevant information about the hospital stay, medication, lifestyle interventions and follow-up treatment.MethodsSemi-structured interviews with n = 12 physicians were conducted at Heidelberg University Hospital between February and April 2020. Qualitative content analysis was carried out using MAXQDA.ResultsPhysicians reported gaining information, providing information, and answering open-ended questions as the purpose of the discharge interview. Challenges in conducting discharge interviews were related to finding a common language, patient-related challenges, conditions of everyday ward life, and lack of training. Physicians reported receiving no explicit training on discharge interviews. While professional experience seems to mitigate the lack of training, some physicians expressed a prevailing sense of insecurity.ConclusionThe lack of preparation for discharge interviews in medical school makes it particularly challenging for physicians to translate their theoretical knowledge into patient-centered discharge communication. Medical training on discharge interviews should be expanded in terms of theoretical input on the ideal content, its purpose and potential (e.g. in reducing readmissions), as well as practical exercises.
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