Health professionals' practices and perspectives of post-stroke coordinated discharge planning: a national survey

Background It is best practice for stroke services to coordinate discharge care plans with primary/community care providers to ensure continuity of care. This study aimed to describe health professionals' practices in stroke discharge planning within Australia and the factors influencing whether discharge planning is coordinated between hospital and primary/community care providers.Methods A mixed-methods survey informed by the Theoretical Domains Framework was distributed nationally to stroke health professionals regarding post-stroke discharge planning practices and factors influencing coordinated discharge planning (CDP). Data were analysed using descriptive statistics and content analysis.Results Data from 42 participants working in hospital-based services were analysed. Participants reported that post-stroke CDP did not consistently occur across care providers. Three themes relating to perceived CDP needs were identified: (1) a need to improve coordination between care providers, (2) service-specific management of the discharge process, and (3) addressing the needs of the stroke survivor and family. The main perceived barriers were the socio-political context and health professionals' beliefs about capabilities. The main perceived facilitators were health professionals' social/professional role and identity, knowledge, and intentions. The organisation domain was perceived as both a barrier and facilitator to CDP.Conclusion Australian health professionals working in hospital-based services believe that CDP promotes optimal outcomes for stroke survivors, but experience implementation challenges. Efforts made by organisations to ensure workplace culture and resources support the CDP process through policies and procedures may improve practice. Tailored implementation strategies need to be designed and tested to address identified barriers. Going home after a stroke is a significant milestone in the stroke recovery journey; however, stroke survivors have unmet needs in relation to discharge planning processes. Our survey found that healthcare professionals working in stroke care experience challenges in coordinating care between services, resulting in inconsistent practice. Our study suggests that clearer guidance and support is needed to improve communication between hospital-based clinicians and primary and community care providers, which will benefit outcomes for stroke survivors.This article belongs to the Collection Clinical Implementation to Optimise Outcomes.