An analysis of decision making in discharge planning.
A repeated-measures design was used to examine medical professionals' discharge planning strategies. Physicians, residents, nurses, and social workers were presented with 16 hypothetical case scenarios and asked to: (1) rate the appropriateness of four discharge options (nursing home, community nursing, adult day, and outpatient clinic care), and (2) select the most appropriate discharge plan for each case. Four within-group variables were included in the scenarios: physical impairment, caregiver availability, follow-up required, and patient compliance. Decisions were greatly influenced by caregiver availability. When a caregiver was available, respondents preferred community-based options (i.e., community nursing care or outpatient clinic); if the case involved complications (i.e., severe physical impairment, heavy follow-up, noncompliant patient), they considered community nursing care more appropriate than outpatient clinic. When a caregiver was unavailable, respondents preferred institution-based options (i.e., nursing home or adult daycare); if there were complications, they considered nursing home more appropriate than adult daycare.
Hines Veterans Administration Hospital, IL 60141.
F M
FM
Weaver
F B
FB
Bryant
D000359:Aftercare / Q000706:statistics & numerical data*; D000704:Analysis of Variance; D003657:Decision Making; D005069:Evaluation Studies as Topic; D006787:Hospitals, Veterans / Q000458:organization & administration*; D006801:Humans; D008505:Medical Staff, Hospital; D008962:Models, Theoretical; D015999:Multivariate Analysis; D009741:Nursing Staff, Hospital; D010351:Patient Discharge; D011795:Surveys and Questionnaires; D014481:United States