Rapid discharge from hospital in the last days of life: An evaluation of the key issues and the contribution of an end of life discharge sister role

Background When the time comes, most people wish to die at home. Nevertheless, many deaths occur in hospital, often because of delays in the discharge process. This study explored the issues surrounding rapid discharge from hospital in the final days of life, and evaluated the contribution of a discharge sister role. Methods A qualitative design was used, incorporating focus groups and interviews with key stakeholders. Results A total of 75 staff and 7 carers participated. Participants highlighted the small window of opportunity available to facilitate a rapid but safe discharge from hospital. Early recognition of the last days of life was vital as was the availability of a skilled healthcare professional, such as the discharge sister, to co-ordinate the patient’s journey from hospital to preferred place of death. Conclusions Rapid discharge is challenging and requires high levels of skill. The discharge sister navigated complex organisational systems to facilitate rapid discharge for those who might otherwise have died in hospital.