Exploring the quality of discharge planning processes in mental health care: The healthcare provider perspective

Background: While discharge planning is essential to ensure continuity of care as patients transition from hospital to community settings, there is currently little agreement on how to effectively assess its quality in mental healthcare settings. The purpose of this qualitative study was to identify domains and indicators reflective of quality discharge planning processes in mental healthcare settings. Methods: Two focus groups were conducted with mental healthcare providers (n=7) to validate discharge planning domains and indicators identified through a preceding concept analysis and literature review. Thematic analysis was used to identify common themes from the focus group discussions. Member checking was conducted to enhance credibility and ensure data saturation. Results: Discharge planning was found to be a multifaceted concept with 73 quality indicators across six domains: Comprehensive Needs Assessment ; Collaborative, Patient-Centered Care ; Resource Availability Management ; Care and Service Coordination; Discharge Planner Role ; and Discharge Plan . Overall, participants broadly confirmed the concept analysis and literature review findings and identified two additional domains. Information Gathering and Synthesis refers to the process of constructing a patient’s pathway to hospitalization by gathering contextual information about their history, such as reasons for admission and previous hospitalizations, reviewing documentation completed by other healthcare providers, and determining a patient’s legal status. Patient Capacity Assessment reflects the assessments and evaluations to determine a patient’s mental capacity to consent, as well as decision-making ability for treatment and finances. Conclusions: This study provides clarity and guidance for delivering patient-centered, collaborative discharge planning care to meet mental health patients’ diverse needs as they transition from hospital to community settings. Establishing valid indicators to evaluate discharge processes is a critical step towards strengthening mental healthcare services, as it will facilitate the development of a discharge planning measurement instrument, identification of practice and knowledge gaps in continuity of care, and inform organizational process improvements to improve quality and safety of patient care. The validated domains and indicators can inform the development of discharge planning guidelines, standards, and protocols to enhance clinical practice and patient outcomes.