Discharge Planning- December 2011


Discharge Planning - Evidence Update

December 2011


Welcome to the December bulletin on Discharge Planning being produced by the HEFT Library Services.

This bulletin is produced to support VITAL for Nurses core skills programme developed in the Trust. This

issue will highlight evidence published in the previous four weeks. Full text articles can be accessed with

your HEFT Athens ID.


Admission prevention



Guess who.

Lewis, G.; Curry, N.;Bardsley, M.

The Health Service Journal. October; 121(6279) p. 23-25

The article argues that accurate prediction of patients at risk is fundamental to preventing hospital admission.

Looks at some of the predictive tools and models which are available to commissioners.


Bed management



Patient safety in patients who occupy beds on clinically inappropriate wards.



Goulding, L et al

BMJ Quality and Safety. Epub 18 November

The aim of this article is to explore NHS staff members' perceptions and experiences of the contributory factors

that may underpin patient safety issues in those who are placed on a hospital ward that would not normally treat

their illness (such patients are often called 'outliers' 'sleep outs' or 'boarders').




Capacity planning

Nothing to report.




Discharge coordination



Nothing to report.



Discharge process



Improved communication in post-ICU care by improving writing of ICU discharge


Medlock, S et al

BMJ Quality and Safety. November, 20(11) p. 967-973

This article highlights a multifaceted intervention that was performed to improve communication in patient hand-

off from the intensive care unit (ICU) to the wards by improving the timeliness of discharge letters.

Available in fulltext at Highwire Press


The efficacy of computer-enabled discharge communication interventions.

Motamedi, S.M et al

BMJ Quality and Safety. May, 20(5) p. 403-415

The   objective   of  this   systematic   review  was  to   evaluate   the   efficacy  of   computer-enabled         discharge

communication compared with traditional communication for patients discharged from acute care hospitals.

Available in fulltext at Highwire Press


Education and Practice

Nothing to report.


Estimating dates for discharge

Nothing to report.


Multidisciplinary team discharges

Nothing to report.


Nurse-led discharge

Nothing to report.


Patient centred discharges

Nothing to report.





Inpatient elderly care : reducing re-admission rates.

Xu, G et al

British Journal of Health care Management. December; 17(12) p.599-602

Looks at the issue of outlying elderly patients in other speciality wards (when demand for medical beds outstrips

capacity in medical wards). Found that this procedure is very inefficient, and that it leads to patient readmission.


Quality and cost analysis of nurse staffing, discharge preparation, and

postdischarge utilization.

Weiss, M E et al

Health Services Research. October; 46(5) p. 1473-94

The aim of this study was to determine the impact of unit-level nurse staffing on quality of discharge teaching,

patient perception of discharge readiness, and postdischarge readmission and emergency department (ED)

visits, and cost-benefit of adjustments to unit nurse staffing.

Available in fulltext at EBSCO Host


Blood test reduces hospital readmissions.

Case Management Advisor. October; 22 p. 15-15

In a study reported in the American Journal of Cardiology, the authors found that They found that patients whose

protein levels dropped by less than 50% over the course of their hospital stay were 57% more likely to be

readmitted or die within a year than those whose levels dropped by a greater percentage.

Available in fulltext at EBSCO Host


Following up care cuts readmissions.

Case Management Advisor. October; 22 p. 13-14

Available in fulltext at EBSCO Host


6 ways to prevent hospital readmissions.

Case Management Advisor. October; 22 p. 12-12

The authors state that to prevent hospital readmissions, gather as much information as possible about the

patient's discharge needs, psycho-social needs, and support systems in the community.

Available in fulltext at EBSCO Host


Interventions to reduce 30-day rehospitalization: a systematic review.

Hansen, L O et al

Annals of Internal Medicine. October; 155(8) p. 520-528

The purpose of this article is to describe interventions evaluated in studies aimed at reducing rehospitalization

within 30 days of discharge.

Available in fulltext at EBSCO Host


Risk prediction models for hospital readmission: a systematic review.



Kansagara, D et al

JAMA: Journal of the American Medical Association. October; 306(15) p. 1688-1698

The aim was to summarize validated readmission risk prediction models, describe their performance, and assess

suitability for clinical or administrative use.

Available in fulltext at Highwire Press


Hospital readmissions--not just a measure of quality.

Kangovi S, and Grande, D

JAMA: Journal of the American Medical Association. October; 306(16) p. 1796-1797

In this article, the authors propose a broader framework that can be identify alternative strategies to reduce

readmissions. Available in fulltext at Highwire Press


Teach-back program reduces readmissions.

Healthcare Benchmarks & Quality Improvement. November; 18(11) p. 123-125

The project targeted patients admitted to the hospital with a primary or secondary diagnosis of heart failure. The

goals were to: (1) implement a standardized work process that incorporating teach back as a means of improving

care transitions for patients with heart failure; and (2) reduce the readmission rate for this patient population.

Available in fulltext here.


Hospital readmissions for COPD highest among black patients.

AHRQ Research Activities. November; 375 p. 15-15

The reports states that for patients age 40 and over with chronic obstructive pulmonary disease (COPD), hospital

readmissions within 30 days of initial treatment were 30 percent higher among Blacks than Hispanics or Asians

and Pacific Islanders and about 9 percent higher than Whites in USA for 2008.

Available in fulltext here.


Impacting readmission rates and patient satisfaction: Results of a discharge pharmacist

pilot program

Wilkinson S.T et al

Hospital Pharmacy. November; 46(11) p. 876-883

The objective of this article was to study the impact of a pharmacist-driven discharge counseling program for

high-risk patients identified by BOOST (Better Outcomes for Older adults through Safe Transitions) criteria on

30-day readmission rates.


Coaching helps cut readmissions

Hospital Case Management. October; 19(10) p. 155-156

Available in fulltext at ProQuest (Legacy Platform) Available in fulltext at EBSCO Host


To prevent readmissions, coordinate services post-discharge.

Case Management Advisor. October; 22 p. 23-25

The articles states that the best way to prevent hospital readmissions is to make sure patients are better managed

and receive the care they need after they leave the hospital.

Available in fulltext at EBSCO Host


Look beyond hospital walls to avoid readmissions

Case Management Advisor. October; 22 p. 16-18

The article states that hospitals also have to take into consideration what happens to patients after they leave

the acute care setting in order to avoid readmissions.       Available in fulltext at EBSCO Host


Reducing readmissions: Case management's critical role.

Cesta, T

Case Management Advisor. October; 22 p. 8-11      Available in fulltext at EBSCO Host


SAFETY Monitor. Decreasing 30-Day Readmission Rates.

Lacker, C

American Journal of Nursing. November; 111(11) p.65-69


A new multimodal geriatric discharge-planning intervention to prevent emergency visits

and rehospitalizations of older adults.

Legrain, S et al

Journal of the American Geriatrics Society. November; 59(11) p. 2017-2028

The objective of this study was to determine whether a new multimodal comprehensive discharge-planning

intervention  would  reduce  emergency  rehospitalizations  or  emergency  department  (ED)  visits  for  very old


Available in fulltext at EBSCO Host EJS


Simple discharges and Complex discharges



Patterns and predictors of short-term death after emergency department




Gabayan, GZ et al

Annals of Emergency Medicine. December; 58(6) p. 551-558.e2

Using administrative data from an integrated health system, the authors escribe characteristics and predictors

of patients who experienced 7-day death after ED discharge.

Available in fulltext at MD Consult; Note: You will need to register (free of charge) with MD Consult the first time

you use it


Further Information

Multiple sources – websites, journals and healthcare databases – have been searched for evidence

published in the last four weeks are identified and highlighted here. For a detailed list of sources that

have been scanned, please contact [email protected] or ext 47836 (Good Hope


Please login with your Athens ID on www.evidence.nhs.uk ‘before’ clicking on any of the journal full text

links in this bulletin for seamless access.

To  request articles where there is  no  full text  link, please complete an online article request       form

available on HEFT Library website www.heftlibrary.nhs.uk under ‘Electronic Forms’ menu. Please note

that there is now a charge of £1 for such requests.

For more information on how to register for Athens, access the Athens Registration leaflet via HEFT

Library website www.heftlibrary.nhs.uk under the ‘Publications’ menu.