Thrown in at the deep end: a qualitative study with physicians on the purpose and challenges of discharge interviews

ABSTRACT

Objectives

Against the backdrop of poor discharge communication in hospitals, this study explores the purpose of discharge interviews from the physicians’ perspective and the challenges they are confronted with. Discharge interviews are legally required in Germany as part of the discharge management. Led by the ward physician, the discharge interview should summarize relevant information about the hospital stay, medication, lifestyle interventions and follow-up treatment.

Methods

Semi-structured interviews with n = 12 physicians were conducted at Heidelberg University Hospital between February and April 2020. Qualitative content analysis was carried out using MAXQDA.

Results

Physicians reported gaining information, providing information, and answering open-ended questions as the purpose of the discharge interview. Challenges in conducting discharge interviews were related to finding a common language, patient-related challenges, conditions of everyday ward life, and lack of training. Physicians reported receiving no explicit training on discharge interviews. While professional experience seems to mitigate the lack of training, some physicians expressed a prevailing sense of insecurity.

Conclusion

The lack of preparation for discharge interviews in medical school makes it particularly challenging for physicians to translate their theoretical knowledge into patient-centered discharge communication. Medical training on discharge interviews should be expanded in terms of theoretical input on the ideal content, its purpose and potential (e.g. in reducing readmissions), as well as practical exercises.

KEYWORDS:

• Discharge interview
• physician-patient communication
• medical training
• patient education
• health literacy
• postgraduate medicine

Declaration of financial/other relationships

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties. A reviewer on this manuscript has received an honorarium from IPGM for their review work. Peer reviewers on this manuscript have no other relevant financial relationships or otherwise to disclose.

Acknowledgments

The preliminary results were presented at a symposium on health literacy organised by the German Ministry of Health in Berlin 2022. In addition, the preliminary results were presented at a conference of the GMA (Society for Medical Education in Germany) in Halle an der Saale 2022.

Author contributions

Lorena Morschek: Conceptualization, methodology, formal analysis, writing – original draft, review & editing. Jobst-Hendrik Schultz: Conceptualization, methodology, review & editing. Ricarda Wigbels: Methodology, formal analysis. Nadja Gebhardt: Methodology. Cassandra Derreza-Greeven: Formal Analysis. Hans-Christoph Friederich: Conceptualization. Alexandra Noll: Conceptualization. Inga Unger: Conceptualization. Christoph Nikendei: Conceptualization, methodology, review & editing. Till Johannes Bugaj: Conceptualization, methodology, formal analysis, writing, review & editing, supervision.

Additional information

Funding

This work was financially supported by a resolution of the German Bundestag by the Federal Government/Ministry of Health [2519FSB520].