Patient and family member experience of hospital readmission following critical illness

Abstract

Background: Hospital readmission following critical illness is common. There is limited data which examines the patient and family perspective of hospital readmission. Understanding the impact of readmissions from a patient perspective can potentially help design meaningful clinical pathways to support improvements in care.

Objectives: The aim of this qualitative analysis was to explore the experience of patient and family members during readmission to hospital following critical illness. We also sought to understand any perceived drivers of these readmissions from a patient and caregiver perspective.

Methods: Qualitative descriptive study using semi-structured interviews. Data were analysed using a thematic content analysis approach based on Miles and Huberman's framework.

Setting and participants: This study was conducted in a large inner city teaching hospital in the UK. Critical care survivors who had been readmitted to hospital following critical illness and their family members were invited to participate in interviews during the readmission episode.

Results: Interviews were undertaken with 20 participants (15 patients and 5 family members). We derived five themes related to hospital readmission: access to primary care; ongoing physiological disturbance; discharge planning and information provision; treatment burden; and carer strain and social care access.

Conclusions: There are multiple perceived drivers of readmission to hospital following critical illness from a patient and family member perspective. The experience of readmission can be potentially traumatic for those involved. Future research should examine how discharge planning can be improved and how family members can be effectively supported in the post-hospital discharge period.

Implications for practice: Clear discharge planning and information provision is required to ensure effective care for survivors of critical illness. Family members of survivors could also benefit from dedicated support across the continuum of care.

Keywords: Critical care; Discharge; Hospital readmission; Recovery; Treatment burden.