Hospital discharge program – implementation and outcomes
Researchers: Hana Kerzman1
- Sheba Medical Center
Background: The implementation of an adaptable hospital discharge program is essential for continuity of patient care in the community. The literature indicates that one in five hospital discharges is followed by medical complications and readmission.
Objectives: To examine the effect of the discharge nurse model on the quality of the discharge process and on the patient's knowledge about medication therapy and self-care, patient satisfaction with hospitalization and with the discharge process and utilization of community health services and readmission.
Method: A prospective intervention study was carried out in four internal-medical departments.
The study included a control group – 192 patients who were discharged by a nurse during a regular shift and an interventional group – 202 patients who participated in the discharge nurse model and were discharged by a dedicated nurse.
Data were collected from nursing discharge letters, telephone interviews conducted one week and one month after discharge and from medical records.
The study included a control group – 192 patients who were discharged by a nurse during a regular shift and an interventional group – 202 patients who participated in the discharge nurse model and were discharged by a dedicated nurse.
Data were collected from nursing discharge letters, telephone interviews conducted one week and one month after discharge and from medical records.
Findings: Patients discharged by a dedicated discharge nurse showed greater knowledge about medication therapy and self-care and reported greater general satisfaction with hospitalization and with the discharge process than did patients in the control group. This finding corresponds to a higher score on quality of nursing discharge process. However, no differences were found between the two groups regarding post-discharge use of health services and readmission.
Conclusions: The research established improvement in the quality of nursing discharge and patient's self-care knowledge and satisfaction through the application of the discharge nurse model. Teaching of patients and caregivers were facilitated by utilization of this model. Better-informed patients are likely to benefit from better self-care and higher compliance with prescribed medication, thus improving their quality of life following discharge.
Policy Recommendations: Nurses have a pivotal role in the discharge of patients from hospital and a nurse-led discharge process promotes the quality of the discharge of patients.
Research number: R/226/2015
Research end date: 11/2018