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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
letters.
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.
Readmissions
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
inpatients.
Available in fulltext at EBSCO Host EJS
Simple discharges and Complex discharges
Patterns and predictors of short-term death after emergency department
discharge
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
Hospital)
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.
