Improving the discharge planning process: a systems study

The complexity of the discharge planning process is such that it is often difficult to achieve in a totally efficient and effective manner. In this paper a systems approach is adopted in analysing the discharge planning process in a general surgical ward in order to understand better the nature of this complexity. Adopting a soft systems methodology it is shown that the major issues to be addressed relate to the need for a more seamless service provision and more effective utilisation of resources. Conceptual models are formulated which enable comparison to be made between current provision and the issues that need to be addressed. This in turn results in the creation of an agenda of items for change, from cultural, organisational and technological perspectives, which can be considered in terms of their feasibility and desirability. Key proposals highlighted, so as to improve discharge planning, include: the need for greater co-operation between the many healthcare professions involved; the adoption, particularly on the part of nursing staff, of a more holistic approach with regard to the needs of their patients; enhancing the utilisation of nursing staff; and moving towards a greater adoption of information and communication technologies as a means of achieving more effective communication. More generally, the paper provides an example of the role that soft systems analysis can play as an aid in dealing with the complexities of healthcare processes and their management.