Staff perceptions of discharge planning: a challenge for quality improvement.

One hundred staff in three acute care public hospitals were asked about their perceptions of successes and failures of their discharge planning activities. The intention was to highlight ways in which the quality of discharge planning could be improved within the acute hospital setting. Generally staff described failures more commonly than successes, with a number of key failures being identified, including problems associated with vacating beds, lack of appropriate staff, patients and career education about discharge activities, general process issues, problems associated with community service provision and patients who are difficult to discharge. Staff identified the lack of feedback on the outcome of their efforts as a source of frustration and a barrier to improving discharge planning activities. The challenges for improving the quality of discharge planning in the acute hospital setting would appear to be in establishing appropriate structures and processes that promote interaction between staff, patients and community providers, and provide incentives for behavioural change.