Barriers and Facilitators to the Implementation of Discharge Preparation Services for Elderly Patients with Multimorbidity—A Qualitative Study Using the Consolidated Framework for Implementation Research (CFIR)

Purpose To explore barriers and facilitators to implementing a discharge preparation program for elderly patients with multimorbidity, and to inform improvements in this service. Methods We developed semi-structured interview guides based on the Consolidated Framework for Implementation Research (CFIR). Using purposive sampling, we recruited 18 medical staff from a tertiary hospital in Urumqi and conducted interviews with 6 patients and 6 caregivers from the same hospital's service population between November and December 2025. Data were analyzed deductively using CFIR as the coding framework. NVivo 15.0 was used for data management and analysis. Results The findings encompassed 20 constructs across the four CFIR domains (Innovation, Outer Setting, Inner Setting, and Individuals), identifying 11 facilitators, 14 barriers, and 2 neutral factors. Key implementation facilitators included a reliable evidence base, favorable environmental conditions and resources, multidisciplinary team establishment, and leadership support. Primary barriers comprised intervention complexity, increased labor costs, incomplete policies and models, lack of financial incentives, and poor compliance. Conclusion The implementation of discharge preparation services for elderly patients with multimorbidity is influenced by multiple factors. Developing targeted strategies to address identified barriers is essential for facilitating successful implementation.