Background: Embedded in our stroke clinical practice guidelines, a written discharge summary should transfer care and information from a hospital team to a general practitioner (GP) to support continuity of stroke care. However, stroke survivors and caregivers report insufficient post-discharge support and reduced participation in meaningful activities. It is not known if current discharge communication practices sufficiently support the continuity of care after stroke.
Aims: To understand GPs’ perspectives of discharge communication supporting continuity of stroke care.
Methods: A qualitative descriptive study was completed. Semi-structured telephone interviews were conducted with n=40 GPs from 15 of 31 Australian Primary Health Networks between April-September 2020. Data were analysed using a six-step thematic analysis approach, with double coding and member-checking for increased rigor.
Results: GPs described written discharge summaries as inadequate to convey an understanding of ongoing rehabilitation needed to support continuity of stroke care. As discharge communication processes were seen as disconnected, GPs suggested a multidisciplinary team approach across care settings as a potential solution. Challenges in accessing discharge care plans were noted barriers, whereas shared understandings of care needs and recovery goals were identified enablers.
Conclusion: Collaboration between stroke survivors, caregivers, allied health, and GPs is essential to share an understanding of care needs and recovery priorities. The study findings suggest that team-based care planning across care settings and the provision of team-based care in the community may improve continuity of care post-discharge.