Nottingham University Business School

Centre for Health Innovation, Leadership and Learning (CHILL)

Safe Hospital Discharge

An ethnographic study of knowledge sharing across the boundaries between care processes, services and organisations: the contributions to safe hospital discharge.

Hospital discharge is a vulnerable stage in the patient pathway. Research highlights communication failures and the problems of co-ordination as resulting in delayed, poorly timed and unsafe discharges. The complexity of hospital discharge exemplifies the threats to patient safety found ‘between’ care processes and organisations. In developing this perspective, safe discharge is seen as relying upon enhanced knowledge sharing and collaboration between stakeholders, which can mitigate system complexity and promote safety.

Project aims

To identify interventions and practices that support knowledge sharing and collaboration in the processes of discharge planning and care transition.

Project highlights

The study suggests four areas of change that might enhance knowledge sharing, reduce system complexity and promote safety:

  • knowledge brokers, in the form of discharge co-ordinators, can facilitate knowledge sharing and co-ordination
  • co-location and functional proximity of stakeholders can support knowledge sharing and mutual appreciation and alignment of divergent practices
  • local cultures should prioritise and value collaboration
  • organisational resources, procedures and leadership should be aligned to fostering knowledge sharing and collaborative working

Project team

Principal Investigator: Professor Justin Waring, University of Nottingham

CHILL team: Dr. Simon Bishop and Dr. Fiona Marshall, University of Nottingham

Funder: NIHR Health Services and Delivery Research (HS&DR) Programme

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Nottingham University Business School

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