title: Organisational silos: affecting the discharge of elderly patients.
abstract: OBJECTIVE
  This paper aims to explore the unintentional formation of internal functional barriers, (organisational silos) during moves towards departmental efficiency, within an acute trust, and the subsequent effects on the discharge process in elderly patients.
  
  
  METHODS
  This paper presents some of the findings from a qualitative study examining the role of the nurse in the discharge process. Semi-structured interviews were conducted with a purposively selected cohesive sample of 28 registered nurses, from the medical and elderly care wards in an NHS Acute Trust. The interviews were taped, transcribed and their content analysed.
  
  
  RESULTS
  The problems associated with patient discharge were frequently operational. Each part of the process was hindered, often inadvertently, by attempts on the part of individuals, departments and services to make themselves efficient, without regard for the resulting organisational consequences. This left the ward nurses attempting to overcome the obstacles in an attempt to effectively discharge patients, within a required period of time.
  
  
  CONCLUSIONS
  It is recognised that, the perceptions of those not participating in the study may have been different to those who did participate. As a small study in one trust the results may not be generalisable.
  
  
  CONCLUSIONS
  It is imperative that evaluation of operational changes is undertaken, with particular regard to the consequences of change, for other services, patients and clients.
  
  
  CONCLUSIONS
  This type of study can provide a method of diagnosing organisational problems, especially in areas that are reliant on inter-professional and departmental collaboration.
authors.affiliation: School of Health and Social Care, University of Greenwich, London, UK. j.m.scott@gre.ac.uk
authors.forename: Janet M
authors.initials: JM
authors.lastname: Scott
authors.forename: Peri
authors.initials: P
authors.lastname: Hawkins
mesh_terms: D000368:Aged; D017598:Efficiency, Organizational; D006779:Hospitals, Public / Q000458:organization & administration*; D006801:Humans; D007407:Interviews as Topic; D024802:Nurse's Role; D010351:Patient Discharge / Q000592:standards*; D013222:State Medicine; D006113:United Kingdom