From bottleneck to efficiency: Key areas for improving discharge management in healthcare - a qualitative study.

Abstract

Background: In Mecklenburg-Western Pomerania, multidisciplinary round tables bring together stakeholders from the healthcare sector to jointly develop and advance solutions for regional care challenges on a semi-annual basis. In a sparsely populated state with distinct structural and service-related difficulties, these collaborative formats play a key role in improving discharge management. Against this backdrop, the present study explores the main fields of action required to enhance discharge processes in rural areas of Mecklenburg-Western Pomerania. It aims to prioritise the key challenges, objectives, and measures that can contribute to a more efficient and patient-centred continuum of care following hospital discharge.

Methods: Guideline-based group discussions were conducted at the round tables in Demmin, Pasewalk, Parchim and Ueckermünde and analysed using qualitative content analysis. To prioritise key topics and measures, a dialogue-based structural mapping method (Strukturlegetechnik) was applied. This approach enables the reconstruction of participants' subjective theories through consensus-oriented discussions and visual mapping of conceptual relationships.

Results: In four focus group discussions involving a total of 30 participants, three main areas for action were emphasised: the expansion of networks and binding coordination structures, the use of digital tools such as online platforms and telemedicine, and the development of tailored support services for vulnerable groups. In addition, prevention, health education, citizen participation and public relations were highlighted as essential cross-cutting tasks.

Discussion & conclusion: To ensure sustainable healthcare provision in rural areas, it is essential to establish stable networks that meet on a regular basis and have reliable funding. The targeted expansion of telemedicine, digital communication platforms and capacity monitoring systems should be pursued to strengthen cross-sector collaboration and reduce gaps in service delivery.