66 Is “Medically Fit for Discharge” Ambiguous and Misleading to Patients? A Health Service Study

NHS England (2015) Monthly Delayed Transfer of Care Situation Report states that “Medically Fit for discharge” or “Clinically optimized” is used at the point at which care and assessment can safely be continued in a non-acute setting. However, elderly patients are either frail or unlikely to be fit physically or medically before they are discharged from hospitals. A number of complaint meetings with patients and relatives suggested that doctors and healthcare professionals should consider changing the language used during discharges. The aim of the study was to identify the challenges with the use of variable languages and to provide standardization of the discharge Languages that seems appropriate for the patients within our organization. Method In February 2019, a discussion with major stakeholders at Basildon and Thurrock University Hospital F. NHS Trust including Medical Director and management teams, suggested the need to conduct a staff survey to explore the need for standardization of discharge languages. The survey was sent by emails to healthcare professionals between 6th June 2019 and 1st July 2019. There were 115 responders. Results The proportion of responders between doctors and other allied healthcare professionals was 58% and 42% respectively. 75% of responders reported the use of the term “Medically fit” or “Clinically optimized for discharge” had been challenged by patients or relatives. 61% of staff disapproved the term “Medically Fit for Discharge” and 64% suggested this needed to be changed to “Medically Stable For Discharge” which is more acceptable and meaningful language. Our survey showed that the reasons for the change are that a wrong language is not only ambiguous but misleading amongst our respondents. Conclusion This study has shown concern amongst the staff regarding the language used during the discharge process. Not only is “Medically Fit for Discharge” controversial but occasionally causes dispute between patient/relatives and healthcare professionals. Our project has helped standardize the cultural language to “Medically Stable For Discharge”. This resonates better to patients and enhances their experience and also reduces anxiety caused by ambiguous language. Further study will be required to know how this reduces the complaints rate and delayed transfer of care within our Health service.