The role of an intermediate unit in a clinical pathway

INTRODUCTION: Different care models have been established to achieve more coordinated clinical pathways for older patients in the transition between hospital and home. This study explores an intermediate unit’s role in a clinical pathway for older patients with somatic diseases. THEORY AND METHODS: Qualitative data were collected via interviews, observations, and a questionnaire. Participants included patients and healthcare providers within both specialist and primary healthcare. Transcripts of interviews and field notes were analyzed using a method of systematic text condensation. RESULTS: Healthcare providers in the hospital, the intermediate unit, and the municipalities have different opinions about who is a ‘suitable’ patient for the unit and what is the proper time for hospital discharge. This results in time-consuming negotiations between the hospital and the unit. Incompatible computer systems increase the healthcare provider’s workload. Several informants are doubtful as to whether a stay in the unit is useful to the patients, while the patients are mostly pleased with their stay and the transferral. CONCLUSION AND DISCUSSION: This study describes challenges that may occur when a new unit is established in an existing healthcare system in order to achieve an appropriate clinical pathway from hospital to home.