Hospital discharge planning: a qualitative study of new-graduate physiotherapists' experiences

Romany Martin, Andrew M. Phan, Shaun Tan, A. Mandrusiak, R. Forbes
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Abstract

Purpose: Discharge planning constitutes a large part of a physiotherapist's role when working in hospital settings. The challenges of decision-making relating to discharge planning have been identified by experienced physiotherapists. Despite known challenges associated with the transition from student to clinician, the experiences of new-graduates undertaking discharge planning are largely unknown. Therefore, this study aimed to explore:1)    new-graduate physiotherapists' experiences of discharge planning in hospital settings, and2)    the influence of pre-professional training on their perceived preparedness for discharge planning.Design: A qualitative general inductive approach using semi-structured interviews. New-graduate physiotherapists (n = 14) working in hospital settings were recruited.Finding: Four themes were generated: 1) responding to the pressures associated with discharging patients, 2) complex decision-making, 3) the role of the interprofessional team, and 4) desiring additional context and complexity from pre-professional training.Practice Implications: The study has identified that new-graduates underestimate the extent to which discharge planning features in their roles within hospital settings, and are unaware of the interprofessional practice required. Whilst they felt that their pre-professional training provides the technical skills required for their roles, they felt that they were not prepared for their role within the broader healthcare system, nor the complexity of clinical practice. This study encourages education providers to emphasise the role of physiotherapists within the broader health care system, through highlighting contexts where physiotherapy knowledge can be applied (i.e., discharge planning) and understanding the role of the physiotherapist within the interprofessional team.Limitations: Important perspectives of mentors and other members of the interprofessional team involved in discharge planning have not been included in this study which may have impacted the interpretation of the results.
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出院计划:新生物理治疗师经验的质性研究
目的:出院计划构成了一个很大的物理治疗师的角色,当工作在医院设置。有经验的物理治疗师已经确定了与出院计划有关的决策挑战。尽管从学生到临床医生的转变存在着众所周知的挑战,但新毕业生从事出院计划的经历在很大程度上是未知的。因此,本研究旨在探讨:1)刚毕业的物理治疗师在医院环境中的出院计划经验,以及2)专业前培训对他们感知出院计划准备的影响。设计:采用半结构化访谈的定性一般归纳方法。招募在医院工作的新毕业物理治疗师(n = 14)。发现:产生了四个主题:1)应对与出院患者相关的压力,2)复杂的决策,3)跨专业团队的角色,以及4)希望从专业前培训中获得额外的背景和复杂性。实践启示:研究发现,应届毕业生低估了出院计划在他们在医院环境中的作用,并且没有意识到所需的跨专业实践。虽然他们觉得他们的专业前培训提供了他们的角色所需的技术技能,但他们觉得他们没有为他们在更广泛的医疗保健系统中的角色做好准备,也没有为临床实践的复杂性做好准备。这项研究鼓励教育提供者强调物理治疗师在更广泛的卫生保健系统中的作用,通过强调物理治疗知识可以应用的环境(即,出院计划)和理解物理治疗师在跨专业团队中的作用。局限性:本研究未包括参与出院计划的导师和其他跨专业团队成员的重要观点,这可能会影响结果的解释。
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