Is Routine Discharge Enough? Needs and Perceptions Regarding Discharge and Readmission of Palliative Care Patients and Caregivers

Kuntz AA, Chen VH, Ambady L, Osher B, DesRoches C. Is routine discharge enough? needs and perceptions regarding discharge and readmission of palliative care patients and caregivers. American Journal of Hospice and Palliative Medicine®. Published online January 5, 2025. doi:10.1177/10499091241311222

doi: https://doi.org/10.1177/10499091241311222

This study investigated the hospital discharge process for palliative care patients and their caregivers, focusing on its patient-centeredness, discharge readiness, and links to readmissions. Through 13 semi-structured interviews, researchers identified key themes: symptom burden, relationship to illness, alignment with care providers, and discharge readiness. While pain control was generally well-managed, other physical and emotional symptoms often persisted. Participants expressed low levels of illness understanding and empowerment, with a preference for guidance from care teams. Relationships with bedside nurses and outpatient oncologists were strong, but alignment with inpatient providers was weaker, affecting the overall discharge experience.

The findings highlight unmet needs in discharge planning, including clear communication of next steps, improved post-discharge support, and addressing non-pain symptoms. Participants frequently reported incomplete discharge education, particularly regarding warning signs and care resources. Readmissions were seen as unavoidable, often linked to unresolved symptoms. The study suggests that improving illness understanding, empowering patients and caregivers, and enhancing coordination between inpatient and outpatient providers could strengthen discharge processes and reduce readmissions. Keep reading.