ArticleBMC health services research2024
Identifying factors influencing emerging innovations in hospital discharge decision making in response to system stress: a qualitative study.
Article in BMC health services research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Factors influencing invasive arterial blood pressure monitoring accuracy: a qualitative study using the i-PARIHS framework and personas.BMC nursing · 2026Article
- Clinical nurses as digital guardians: unlocking the key determinants of digital resilience in the AI era.Frontiers in public health · 2026Article
- Navigating the Complexities of Implementing Evidence-Based Respiratory Muscle Training in Post-Mechanical Ventilation Care: A Qualitative Study.Nursing open · 2025Article
- Post-Hospitalization Telerehabilitation is Acceptable and Feasible for Veterans With Dementia: A Secondary Qualitative Study.Journal of the American Medical Directors Association · 2025Article
- Identifying Patient, Care Partner, and Clinician Needs for Functional Recovery Following Hospitalization When Dementia is Present.Journal of the American Medical Directors Association · 2025Article
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7 authors.
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Abstract
backgroundThe purpose of this qualitative study was to identify emergent rehabilitation innovations and clinician perceptions influencing their implementation and outcomes related to hospital discharge decision-making during the Coronavirus 2019 pandemic.
methodsRehabilitation clinicians were recruited from the Veterans Affairs Health Care System and participated in individual semi-structured interviews guided by the integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) framework. Data were analyzed using a rapid qualitative, deductive team-based approach informed by directed content analysis.
resultsTwenty-three rehabilitation clinicians representing physical (N = 11) and occupational therapy (N = 12) participated in the study. Three primary themes were generated: (1) Innovation: emerging innovations in discharge processes included perceived increases in team collaboration, shifts in caseload prioritization, and alternative options for post-acute care. (2) Recipients: innovations emerged as approaches to communicating discharge recommendations changed (in-person to virtual) and strong patient/family preferences to discharge to the home challenged collaborative goal setting; and (3) Context: the ability of rehabilitation clinicians to innovate and the form of innovations were influenced by the broader hospital system, interdisciplinary team dynamics, and policy fluctuations. Innovations described by participants included (1) use of technological modalities for interdisciplinary collaboration, (2) expansion of telehealth modalities to deliver care in the home, (3) changes in acute care case prioritization, and (4) alternative options for discharge directly to home.
conclusionsOur findings reinforce that rehabilitation clinicians developed innovative strategies to quickly adapt to multiple systems-level factors that were changing in the face of the COVID-19 pandemic. Future research is needed to assess the impact of innovations, remediate unintended consequences, and evaluate the implementation of promising innovations to respond to emerging healthcare delivery needs more rapidly.
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