title: Rapid discharge from hospital in the last days of life: an evaluation of key issues and the discharge sister role.
abstract: BACKGROUND
  When the time comes, most people wish to die at home. Nevertheless, many deaths occur in hospital, often because of delays in the discharge process. This study explored the issues surrounding rapid discharge from hospital in the final days of life, and evaluated the contribution of a discharge sister role.
  
  
  METHODS
  A qualitative design was used, incorporating focus groups and interviews with key stakeholders. A total of 75 staff and 7 carers participated.
  
  
  RESULTS
  Participants highlighted the small window of opportunity available to facilitate a rapid but safe discharge from hospital. Early recognition of the last days of life was vital as was the availability of a skilled health professional, such as the discharge sister, to coordinate the patient's journey from hospital to preferred place of death.
  
  
  CONCLUSIONS
  Rapid discharge is challenging and requires high levels of skill. The discharge sister navigated complex organisational systems to facilitate rapid discharge for those who might otherwise have died in hospital.
authors.affiliation: Research Associate, School of Health and Social Care, Teesside University.
authors.forename: Susan
authors.initials: S
authors.lastname: Jones
authors.affiliation: Reader in Nursing, both at the Health and Social Care Institute, School of Health and Social Care, Teesside University.
authors.forename: Sharon
authors.initials: S
authors.lastname: Hamilton
authors.affiliation: Consultant in Palliative Medicine, South Tees Hospitals NHS Foundation Trust.
authors.forename: Alex
authors.initials: A
authors.lastname: Nicholson
mesh_terms: D024802:Nurse's Role; D009741:Nursing Staff, Hospital; D010351:Patient Discharge; D013727:Terminal Care; D006113:United Kingdom
keywords: Discharge planning; Preferred place of death; Rapid discharge