From vision to reality: how to actualize the vision of discharging patients from a hospital, with an increased focus on prevention.
Experiences in creating dialogue possibilities to stimulate interdisciplinary and intersectoral collaboration in hospital discharge and prevention are presented. Time is often a major constraint that persuades decision-makers to avoid using qualitative methodologies in research and development. Quick results are demanded of today's health-care system, not allowing ideas to be implemented or visions owned by professionals. Action-orientated research is used and recommended, despite its time-demanding methodology. A multidisciplinary management team and the authors, over a 2-year period, worked with the development and implementation of 'Preventive Discharge' in a Danish hospital clinic. The empirical starting point, developmental processes, piloting and implementation of the project are described. Earlier research from a literature review on discharge is referenced. The results show that while there are many barriers to dialogue between professions and between organizational levels, it is possible to frame such opportunities and improve interdisciplinary and intersectoral collaboration for health. External supervision may be an effective tool for stimulating dialogue. The testing phase afforded a valuable lesson when pilot-site collaborators, initially not involved in the development of the process tools, reformulated the project to suit their cultural climate while maintaining the project's original aims. Finally, a discussion is presented on actualizing the vision for 'Preventive Discharge'.
Olsen
L
L
The University Hospitals Centre for Nursing and Care Research, Copenhagen, Denmark.
Wagner
L
L
D000368:Aged; D003266:Continuity of Patient Care / Q000458:organization & administration*; D003718:Denmark; D005568:Forms and Records Control; D006801:Humans; D007373:Interinstitutional Relations; D017146:Models, Organizational; D010348:Patient Care Team; D010351:Patient Discharge; D010865:Pilot Projects; D011314:Preventive Health Services / Q000458:organization & administration*; D015397:Program Evaluation; D012216:Rheumatic Diseases / Q000534:rehabilitation