Misused words, misused thoughts: the roles and perceptions of nurses, doctors and social workers involved in the discharge planning process and their affects on communication

Abstract

Providing cost effective health care is a key objective of policy makers. This is predicated upon enhanced responsiveness through seamless working patterns and optimised communication practices. A model of discharge planning and practice is required which enables the appropriate transmission of information across boundaries, allowing more appropriate treatment following acute illness. This thesis examines impediments to the realisation of this vision. In particular: *Are there differing perceptions amongst health care professionals regarding the role of other health care workers? o If different perceptions do exist, how are they formed and how do they become current? " Does this affect communication within the discharge planning process? " How do such perceptions affect service provision to service users? Study design. A three-phase ethnomethodological study was conducted. A Likert Scale was used to identify common factors influencing the discharge planning process. Interviews were carried out with personnel involved in discharge planning at two acute care facilities and GP practices. Interviews were also conducted with service users before and after their discharge from hospital, Findings. Language use among staff served to achieve consensus and mediate conflict, producing a shared vision of a social reality that was favourable to occupational groups. Poor information sharing and poor communication allowed sectional interests to dominate as occupational groups attempted to ensure equitable division of labour and use of resources. Time, staffing levels and negative perceptions exacerbate poor communication and are reinforced by it. Strategies are outlined and discussed.