title: Lost in hospital: a qualitative interview study that explores the perceptions of NHS inpatients who spent time on clinically inappropriate hospital wards.
abstract: BACKGROUND
  Prior research suggests that the placement of patients on clinically inappropriate hospital wards may increase the risk of experiencing patient safety issues.
  
  
  OBJECTIVE
  To explore patients' perspectives of the quality and safety of the care received during their inpatient stay on a clinically inappropriate hospital ward.
  
  
  METHODS
  Qualitative study using semi-structured interviews.
  
  
  METHODS
  Nineteen patients who had spent time on at least one clinically inappropriate ward during their hospital stay at a large NHS teaching hospital in England.
  
  
  RESULTS
  Patients would prefer to be treated on the correct specialty ward, but it is generally accepted that this may not be possible. When patients are placed on inappropriate wards, they may lack a sense of belonging. Participants commented on potential failings in communication, medical staff availability, nurses' knowledge and the resources available, each of which may contribute to unsafe care.
  
  
  CONCLUSIONS
  Patients generally acknowledge the need for placement on inappropriate wards due to demand for inpatient beds, but may report dissatisfaction in terms of preference and belonging. Importantly, patients recount issues resulting from this placement that may compromise their safety. Hospital managers should be encouraged to appreciate this insight and potential threat to safe practice and where possible avoid inappropriate ward transfers and admissions. Where such admissions are unavoidable, staff should take action to address the gaps in safety of care that have been identified.
authors.affiliation: Department of Health Sciences, University of York, UK.
authors.forename: Lucy
authors.initials: L
authors.lastname: Goulding
authors.affiliation: Department of Health Sciences, University of York, UK.
authors.forename: Joy
authors.initials: J
authors.lastname: Adamson
authors.affiliation: Department of Health Sciences/Hull York Medical School, University of York, York, UK.
authors.forename: Ian
authors.initials: I
authors.lastname: Watt
authors.affiliation: Bradford Institute for Health Research, Bradford, UK.
authors.forename: John
authors.initials: J
authors.lastname: Wright
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D001509:Bed Occupancy; D003142:Communication; D004739:England; D005260:Female; D006757:Hospital Units / Q000600:supply & distribution*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008505:Medical Staff, Hospital / Q000523:psychology; D008875:Middle Aged; D009313:National Health Programs; D061214:Patient Safety; D017060:Patient Satisfaction; D036301:Qualitative Research; D011787:Quality of Health Care; D055815:Young Adult
keywords: bed occupancy; outliers; patient safety; qualitative research; quality of health care