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A critical systems evaluation of the introduction of a ‘discharge to assess’ service in Kent

Gadsby, Erica Wirrmann, Wistow, Gerald, Billings, Jenny R. (2022) A critical systems evaluation of the introduction of a ‘discharge to assess’ service in Kent. Critical Social Policy, . ISSN 0261-0183. E-ISSN 1461-703X. (doi:10.1177/02610183211065028) (KAR id:92647)

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Official URL:
https://doi.org/10.1177/02610183211065028

Abstract

Discharge to Assess (D2A) models of care have been developed to expedite the process of discharging hospital patients as soon as they are medically fit to leave, thereby improving the efficiency and effectiveness of the healthcare system. This article focuses on the implementation of a D2A model in Kent, England, which formed a case study for a European research programme of improvements in integrated care for older people. It uses the Critical Systems Heuristics framework to examine the implementation process and focuses in particular on why this improvement project proved to be so difficult to implement and why the anticipated outcomes were so elusive. The analysis highlights the value in using critical systems thinking to better evaluate integrated care initiatives, in

particular by identifying more explicitly different stakeholder perspectives and power relationships within the system and its decision environment.

Item Type: Article
DOI/Identification number: 10.1177/02610183211065028
Uncontrolled keywords: critical systems heuristics, discharge to assess, hospital discharge, implementation process, integrated care
Subjects: H Social Sciences > H Social Sciences (General)
Divisions: Divisions > Division for the Study of Law, Society and Social Justice > School of Social Policy, Sociology and Social Research > Centre for Health Services Studies
Depositing User: Helen Wooldridge
Date Deposited: 11 Jan 2022 09:44 UTC
Last Modified: 12 Jan 2022 11:16 UTC
Resource URI: https://kar.kent.ac.uk/id/eprint/92647 (The current URI for this page, for reference purposes)
Gadsby, Erica Wirrmann: https://orcid.org/0000-0002-4151-5911
Billings, Jenny R.: https://orcid.org/0000-0002-5660-9478
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