Hospital discharge planning: A systematic literature review on the support measures that social workers undertake to facilitate older patients' transition from hospital admission back to the community

Abstract

Objectives: To systematically review the literature on measures social workers undertake to facilitate discharge planning for older people in a resource-scarce environment.

Methods: Systematic search of electronic databases for peer-reviewed articles published in English between January 1990 and August 2020. Articles on hospital discharge planning facilitated by social workers for older patients returning home from hospital admission were included. The Mixed Method Appraisal Tool (MMAT) was used to assess quality and risk of bias. The systematic literature review protocol has been registered with PROSPERO on 27 August 2021.

Results: Six studies from Canada and the United States met the eligibility criteria. The most common support measures employed by hospital social workers when discharge planning for older patients were assessment, education, care co-ordination, liaison and engagement with families and providers, conflict resolution, counselling and postdischarge follow-up. Barriers to effective discharge planning were medical complexity, lack of communication, time constraints, limited family support, availability of resources and patient safety. These studies were published between 1993 and 2014 and were not within the Australian context.

Conclusions: There are limited studies on Social Work discharge planning within the Australian context, particularly on how this important service has been impacted by recent aged care reforms. More research on the topic is necessary to fully understand how aged care reforms such as the National Prioritisation System for Home Care Packages have influenced hospital discharge planning and how social workers have adapted their practice to this challenge.

Keywords: aged; community aged care service; home care service; patient discharge; social workers.