Discharge Planning - February 2015


Cochrane Reports

Nothing to report

Admission Prevention

Reducing hospital admissions from nursing homes for older people 2014, , National Institute for Health and Care Excellence.

O'Cathain, A., Knowles, E., Turner, J., Maheswaran, R., Goodacre, S., Hirst, E. & Nicholl, J. 2014, "Explaining variation in emergency admissions: a mixed-methods study of emergency and urgent care systems",

Osborne, K. 2015, "More district nurses needed to reduce hospital admissions", Nursing standard (Royal College of Nursing (Great Britain) : 1987), vol. 29, no. 21, pp. 0.

Smith, P., Sherlaw-Johnson, C., Ariti, C. & Bardsley, M. 2015, Focus on: Hospital admissions from care homes, The Health Foundation; Nuffield Trust.

Bed Management

Gaughan, J. 2014, , Testing the Bed-Blocking Hypothesis: Does Higher Supply of Nursing and Care Homes Reduce Delayed Hospital Discharges? [Homepage of Economics of Social and Health Care Unit], [Online]. Available: Full Text 2015.

Capacity Planning

"Figures reveal extent of bed shortfall", 2014, World of Irish Nursing & Midwifery, vol. 22, no. 7, pp. 8-10
Available from EBSCOhost in Full Text

Allison, S., Bastiampillai, T. & Goldney, R. 2014, "Acute versus sub-acute care beds: Should Australia invest in community beds at the expense of hospital beds?", Australian & New Zealand Journal of Psychiatry, vol. 48, no. 10, pp. 952-955.

Chalkley, S. 2014, "A change in practice to address the added pressures of winter", British Journal of Cardiac Nursing, vol. 9, no. 11, pp. 526
Available from Mark Allen Group in Full Text ;.

Dambaugh, L. & Ecklund, M. 2014, "Transitional Care: Assuring Evidence-Based Practice in Skilled Nursing Facilities", Clinical Nurse Specialist, vol. 28, no. 6, pp. 315.

De, S.,Vieira, Moss, C., Brooks, I., Hood, K. & Nelson, K. 2014, "Unscheduled returns to the emergency department", Australian Nursing and Midwifery Journal, vol. 22, no. 4, pp. 41
Available from EBSCOhost in Full Text ;.

Ghosh, A., Jiao, L., Al-Mutawa, F., O'Neill, C. & Mertz, D. 2014, "Value of an active surveillance policy to document clearance of meticillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci amongst inpatients with prolonged admissions", Journal of Hospital Infection, vol. 88, no. 4, pp. 230
Available from Elsevier in Full Text Note: Collection notes: You will need to register (free of charge) with Clinical Key the first time you use it.

Leary, A. & Baxter, J. 2014, "Impact of lung cancer clinical nurse specialists on emergency admissions", British Journal of Nursing, vol. 23, no. 17, pp. 935
Available from EBSCOhost in Full Text

Madsen, F., Ladelund, S. & Linneberg, A. 2014, "High Levels Of Bed Occupancy Associated With Increased Inpatient And Thirty-Day Hospital Mortality In Denmark", Health affairs, vol. 33, no. 7, pp. 1236-1245.

Phillips, M., Street, M., Kent, B. & Cadeddu, M. 2014, "Determining criteria to assess patient readiness for discharge from postanaesthetic care: an international Delphi study", Journal of Clinical Nursing, vol. 23, no. 23, pp. 3345.

Snow, T.,Newton 2014, "Target to reduce emergency hospital admissions by 3.5%", Emergency Nurse, vol. 22, no. 5, pp. 8
Available from EBSCOhost in Full Text ;.

Sterne, P., Grossman, S., Migliardi, J.,Sue & Swallow, D. 2014, "Nurses' Knowledge of Heart Failure: Implications for Decreasing 30-Day Re-Admission Rates", MedSurg Nursing, vol. 23, no. 5, pp. 321
Available from EBSCOhost in Full Text

Thompson, D. & Connolly, V. 2014, "Can ambulatory emergency care help to streamline services?", Emergency Nurse, vol. 22, no. 7, pp. 18.

Vose, C., Reichard, C., Pool, S., Snyder, M. & Burmeister, D. 2014, "Using LEAN to Improve a Segment of Emergency Department Flow", Journal of Nursing Administration, vol. 44, no. 11, pp. 558.

Discharge Coordination

Nothing to report

Discharge Process

"Respiratory centre will offer support to leave hospital", 2014, Nursing Standard, vol. 29, no. 9, pp. 11-12.

Atwal, A. 2014, "Discharge planning: learning from near misses", International Journal of Therapy & Rehabilitation, vol. 21, no. 9, pp. 408-410
Available from EBSCOhost in Full Text ;.

Murphy, S.O., Barth, B.E., Carlton, E.F., Gleason, M. & Cannon, C.M. 2014, "Does an ED flow coordinator improve patient throughput?", Journal of emergency nursing: JEN : official publication of the Emergency Department Nurses Association, vol. 40, no. 6, pp. 605-612.

Strong, S. & Bettin, A. 2015, "An Initiative to Improve Patient Discharge Satisfaction", Rehabilitation Nursing, vol. 40, no. 1, pp. 52-60.

Waring, J., Marshall, F. & Bishop, S. 2015, "Understanding the occupational and organizational boundaries to safe hospital discharge", Journal of health services research & policy, vol. 20, no. 1 Suppl, pp. 35-44.

Education and Practice

DeCaporale-Ryan, N., Cornell, A., McCann, M., McCormick, K. & Speice, J. 2014, "Hospital to Home: A Geriatric Educational Program on Effective Discharge Planning", Gerontology & geriatrics education, vol. 35, no. 4, pp. 369-380.

Estimating Dates for Discharge

Nothing to report

Multidisciplinary Team Discharges

Nothing to report

Nurse Led Discharge

Chow, S.,Yee & Wong, F.,Yuet 2014, "A randomized controlled trial of a nurse-led case management programme for hospital-discharged older adults with co-morbidities", Journal of advanced nursing, vol. 70, no. 10, pp. 2257
Available from Ovid in Full Text

Harbman, P. 2014, "The development and testing of a nurse practitioner secondary prevention intervention for patients after acute myocardial infarction: A prospective cohort study", International journal of nursing studies, vol. 51, no. 12, pp. 1542-1557.

Ingram, S. & Khan, B. 2014, "Discharge planning in a cardiology out-patient clinic: a clinical audit", International journal of health care quality assurance, vol. 27, no. 7, pp. 573-80.

Missel, M., Schønau, M.,Nanna, Pedersen, J.,Holst & Pedersen, P.,Ulrich 2015, "Transition from Hospital to Daily Life: A Pilot Study", Rehabilitation Nursing, vol. 40, no. 1, pp. 20-30.

Patient Centred Discharge

Nothing to report


"How to do it… Improving readmission rates", 2014, McKnight's Long-Term Care News, vol. 35, no. 10, pp. 30-30
Available from EBSCOhost in Full Text ;.

How Mobile Apps Can Reduce Preventable Readmissions
[Online]. Available: Homepage of Mobile Smith[2015]

Anonymous 2015, "Assessing patients' functional status to identify risks for readmission", Hospital Case Management, vol. 23, no. 1.

Anonymous 2015, "Hospitals are still struggling with reducing readmissions", Hospital Case Management, vol. 23, no. 1, pp. 1-4.

Anonymous 2015, "Team effort reduces readmission rate by 20% in two years", Hospital Case Management, vol. 23, no. 1, pp. 7-8.

Auger, A., Kahn, S., Davis, M. & Simmons, M. 2015, "Pediatric asthma readmission: asthma knowledge is not enough?", Journal of Pediatrics, vol. 166, no. 1, pp. 101-NaN
Available from Elsevier in Full Text Note: Collection notes: You will need to register (free of charge) with Clinical Key the first time you use it.

Auger, K.A., Kenyon, C.C., Feudtner, C. & Davis, M.M. 2014, "Pediatric hospital discharge interventions to reduce subsequent utilization: a systematic review", Journal of hospital medicine, vol. 9, no. 4, pp. 251-260.

Bhatia, R.S., Austin, P.C., Stukel, T.A., Schull, M.J., Chong, A., Tu, J.V. & Lee, D.S. 2014, "Outcomes in patients with heart failure treated in hospitals with varying admission rates: population-based cohort study", BMJ quality & safety, vol. 23, no. 12, pp. 981-988.

Blunt, I., Bardsley, M., Grove, A. & Clarke, A. 2015, "Classifying emergency 30-day readmissions in England using routine hospital data 2004-2010: what is the scope for reduction?", Emergency Medicine Journal, vol. 32, no. 1, pp. 44-51
Available from Highwire Press in Full Text

Brooks Carthon, J.M., Lasater, K.B., Sloane, D.M. & Kutney-Lee, A. 2015, "The quality of hospital work environments and missed nursing care is linked to heart failure readmissions: a cross-sectional study of US hospitals", BMJ quality & safety, .

Christiansen, C.,Fynbo 2015, "Hospital readmission after acute kidney injury-why?*", Critical Care Medicine, vol. 43, no. 2, pp. 490-492
Available from Ovid in Full Text;.

Dugger, A., McBride, S. & Song, H. 2014, "Can Nurses Tell the Future? Creation of a Model Predictive of 30-Day Readmissions", Advances in Nursing Science, vol. 37, no. 4, pp. 315.

Fuller, L., Atkinson, G. & Hughes, S. 2015, "Indications of Biased Risk Adjustment in the Hospital Readmission Reduction Program", Journal of Ambulatory Care Management, vol. 38, no. 1, pp. 39-48.

Gusmano, M., Rodwin, V., Weisz, D., Cottenet, J. & Quantin, C. 2015, "Comparison of rehospitalization rates in France and the United States", Journal of health services research & policy, vol. 20, no. 1, pp. 18-25.

Hosein, F., Roberts, D.J., Turin, T., Zygun, D., Ghali, W.A. & Stelfox, H.T. 2014, "A meta-analysis to derive literature-based benchmarks for readmission and hospital mortality after patient discharge from intensive care", Critical Care (London, England), vol. 18, no. 6, pp. 2558.

Itenov, T.,Skovsgaard & Jensen, J. 2015, "Readmission after intensive care: frequent, hazardous, and possibly preventable", Critical Care Medicine, vol. 43, no. 2, pp. 504-506
Available from Ovid in Full Text;.

Miller, A. & Schaper, M. 2015, "Implementation of a Follow-up Telephone Call Process for Patients at High Risk for Readmission", Journal of nursing care quality, vol. 30, no. 1, pp. 63-71.

Peter, D., Robinson, P., Jordan, M., Lawrence, S., Casey, K. & Salas-Lopez, D. 2015, "Reducing Readmissions Using Teach-Back", Journal of Nursing Administration, vol. 45, no. 1, pp. 35-43.

Simple & Complex Discharges


Bell, C., Hashemi, N., Wieland, F., Lowrey, C. & Kaur, V. 2014, "ACE IMPACT: EVALUATION OF AN INTEGRATED GERIATRIC SERVICE... Acute Care of the Elderly", Age & Ageing, vol. 43, pp. ii7-NaN.

Bowen, A. 2014, "Nurse led discharge : improving efficiency, safely", Clinical Governance : an international journal, vol. 19, no. 2.

Chokshi, D. & Chang, E. 2014, "Preventing early readmissions", JAMA, vol. 312, no. 13, pp. 1344-1345
Available from Ovid in Full Text ;.

Coiera, E., Wang, Y. & Magrabi, F. 2014, "Predicting the cumulative risk of death during hospitalization by modeling weekend, weekday and diurnal mortality risks", BMC Health Services Research, vol. 14, no. 226
Available from EBSCOhost in Full Text

Feng-Hang, C., Pengsheng, N. & Jette, M. 2014, "Does Activity Limitation Predict Discharge Destination for Postacute Care Patients?", American Journal of Physical Medicine & Rehabilitation, vol. 93, no. 9, pp. 782-791.

Goldman, L.E., Sarkar, U., Kessell, E., Guzman, D., Schneidermann, M., Pierluissi, E., Walter, B., Vittinghoff, E., Critchfield, J. & Kushel, M. 2014, "Support from hospital to home for elders: a randomized trial", Annals of Internal Medicine, vol. 161, no. 7, pp. 472-481.

Jeffs, L., Dhalla, I., Cardoso, R. & Bell, M. 2014, "The perspectives of patients, family members and healthcare professionals on readmissions: preventable or inevitable?", Journal of Interprofessional Care, vol. 28, no. 6, pp. 507-513.

Noyes, J., Brenner, M., Fox, P. & Guerin, A. 2014, "Reconceptualizing children's complex discharge with health systems theory: novel integrative review with embedded expert consultation and theory development", Journal of advanced nursing, vol. 70, no. 5, pp. 975
Available from Ovid in Full Text;.

Osborne, K. 2014, "Better discharge for older people could save the NHS pound40 million", Nursing standard (Royal College of Nursing (Great Britain) : 1987), vol. 29, no. 12, pp. 7.

Pérez, A., Reales, P., Barahona, M.J., Romero, M.G. & Miñambres, I. 2014, "Efficacy and feasibility of basal-bolus insulin regimens and a discharge-strategy in hospitalised patients with type 2 diabetes - the HOSMIDIA study", International journal of clinical practice, vol. 68, no. 10, pp. 1264-1272.

Peacock, J. 2014, "Discharge Summary for Medically Complex Infants Transitioning to Primary Care", Neonatal Network, vol. 33, no. 4, pp. 204.

Tan, B., Mulo, B. & Skinner, M. 2014, "Transition from hospital to primary care: an audit of discharge summary - medication changes and follow-up expectations", Internal Medicine Journal, vol. 44, no. 11, pp. 1124-1128.

While, A. 2014, "Admission and discharge of frail elderly people", British journal of community nursing, vol. 19, no. 12, pp. 622
Available from EBSCOhost in Full Text ;.



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