Discharge planning in rehabilitation centers: what about patient participation?

Aim: The goal of this research is to know how patients participate in planning their discharge from rehabilitation centres.We do this by studying patient participation in real-time multidisciplinary meetings and within the health providers-patient interaction.We want first to know what communication processes and strategies of interaction health providers and patients use during meetings. We then study how patients participate within this interactional process. We draw particular attention to how participants introduce and follow up specific activities, how they make DP decisions, and how organisational factors (team and care procedures) and family/carers shape the interaction and the participation of patients.Method: Three rehabilitation centres covering the three language regions in Switzerland will participate in the study. In total, 40 patients and their teams of health professionals (physicians, nurses, occupational therapists, physiotherapists, speech and language pathologists and social workers) will be invited to participate. The multidisciplinary meetings in presence of patientswill be filmed. Conversation analysis (CA) is the selected method to analyse the data. This qualitative method is a well established approach to social scientific investigations of health care processes. It provides insights into the way participants accomplish activities and how they produce actions and make sense of the other’s actions. Analysis will focus on turn-taking,structural and sequence organisation, turn organisation, lexical choice and asymmetries during the interaction. In addition, debriefing sessions in the form of interviews with health professionals and patients will be conducted in order to complement the CA analysis.Expected results: The study will allow us to describe how patients participate in planning their discharge from a rehabilitation centre, and how the team, care procedures and family/carers shape the participation of patients. It will help us to make observations in regards to professional best practices on patient participation in DP and design recommendations at national andinternational levels.