Targeting hospitalised patients for early discharge planning intervention.
OBJECTIVE
The purpose of the study was to describe the ability of an evidence-based discharge planning (DP) decision support tool to identify and prioritise patients appropriate for early DP intervention. Specifically, we aimed to determine whether patients with a high Early Screen for Discharge Planning (ESDP) score report more problems and continuing care needs in the first few weeks after discharge than patients with low ESDP scores.


BACKGROUND
Improved methods are needed to efficiently and accurately identify hospitalised patients at risk of complex discharge plans.


METHODS
A descriptive cross-sectional study was designed using a quality health outcomes framework.


METHODS
The ESDP was administered to 260 adults hospitalised in an academic health centre who returned home after discharge. Problems and continuing care needs were self-reported on the Problems After Discharge Questionnaire - English Version, mailed 6-10 days after discharge.


RESULTS
Patients with high ESDP scores reported significantly more problems [mean, 16·3 (standard deviation ±8·7)] than those with low scores [12·2 (±8·4)]. Within the Problems After Discharge Questionnaire subscales, patients with high ESDP scores reported significantly more problems with personal care, household activities, mobility and physical difficulties than patients with low screen scores. Significantly more of the patients with a high ESDP score received consults to a Discharge Planner and referrals for postacute services than patients with low screen scores.


CONCLUSIONS
The ESDP is effective as a decision support tool in identifying patients to prioritise for early DP intervention.


CONCLUSIONS
Use of an evidence-based DP decision support tool minimises biases inherent in decision-making, promotes efficient use of hospital DP resources, and improves the opportunity for patients to access community resources they need to promote successful recovery after hospitalisation.
Authors: Diane E Holland, PhD, RN, Clinical Nurse Researcher, Mayo Clinic, Eisenberg, Rochester, MN; George J Knafl, PhD, Professor, School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC; Kathryn H Bowles, PhD, RN, FAAN, Associate Professor, Biobehavioral Health Sciences Division, University of Pennsylvania School of Nursing, Philadelphia, PA, USA.
Diane E
DE
Holland
George J
GJ
Knafl
Kathryn H
KH
Bowles
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D006760:Hospitalization; D006801:Humans; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D055815:Young Adult