Discharge Planning – Evidence Update
May-2011
Welcome to the first bulletin on Discharge Planning being produced by the HEFT Library
Services with support from Liz Lees, Consultant Nurse at HEFT. This bulletin is
produced to support VITAL for Nurses core skills programme developed in the Trust.
This first issue will highlight the core documents on Discharge planning that have been
produced in the past and are still highly relevant. Monthly updates from June 2011 will
feature evidence published in the previous four weeks. Full text articles can be accessed
via your HEFT Athens ID.
Core Documents
Ready to Go? Planning the Discharge and the Transfer of Patients from Hospital and
Intermediate Care. Department of Health, March 2010.
Discharge Planning: a summary of DoH guidance Ready to go? Planning the
Discharge and the Transfer of patients from Hospital and Intermediate Care RCN
Publishing Essential Guide, Spring 2010.
Prevention Package for Older People Resources Department of Health, March 2010.
This is a suite of downloadable resources designed to support PCTs, SHAs and Local
Authorities in prioritising and commissioning services that support health and well being of
older people.
Nursing and Midwifery Council – Guidance for Older People on Discharge Planning
Healthcare Inspectorate Wales, March 2010.
The guidance is a review of arrangements in place across the Welsh National Health
Service.
Achieving timely ‘simple’ discharge from hospital : A toolkit for the multi-disciplinary
team Department of Health, August 2004.The toolkit focuses on the practical steps that
health and social care professionals can take to improve discharge.
Discharge from hospital: pathway, process and practice Health and Social Care Joint
Unit and Change Agent Team, January 2003.
This good practice guidance updates and builds on the Hospital Discharge Workbook
published in 1994.
Admission prevention
Reducing hospital readmissions - Lessons from top-performing hospitals
The Commonwealth Fund
April 2011
Proportion of hospital readmissions deemed avoidable: a systematic review
C. van Walraven, et al.
Canadian Medical Association Journal
April 2011
Three unusual ways to reduce A&E admissions
Practical Commissioning
April 2011
Interventions to reduce hospitalizations from nursing homes: Evaluation of the INTERACT
II collaborative quality improvement project
Joseph G. Ouslander, et al.
The Commonwealth Fund
April 2011
Bed management
Title: Perceptions of a 'virtual' acute admission unit.
Citation: Emergency Nurse, December 2010, vol./is. 18/8(12-7), 1354-5752 (2010 Dec)
Author(s): van der Linden, C, van der Linden, N, Lindeboom, R
Abstract: System of bed management developed at a medical centre in the Netherlands,
designed to ease overcrowding in the emergency department by means of a virtual acute
admission unit (VAAU). Full Text: Available in fulltext at EBSCO Host Available in fulltext at
ProQuest (Legacy Platform)
Title: Smoothing inpatient discharges decreases emergency department congestion: A
system dynamics simulation model
Citation: Emergency Medicine Journal, August 2010, vol./is. 27/8(593-598), 1472-
0205;1472-0213 (August 2010) Author(s): Wong H.J., Wu R.C., Caesar M., Abrams H.,
Morra D.
Abstract: To evaluate the daily number of ED beds occupied by inpatients after evenly
distributing inpatient discharges over the course of the week using a computer simulation
model. Full Text: Available in fulltext at Highwire Press
Capacity planning
Title: Collaboration on capacity management.
Citation: Hospital Case Management, 01 September 2010, vol./is. 18/9(140-142), 10870652
Full Text: Available in fulltext at EBSCO Host Available in fulltext at ProQuest (Legacy
Platform)
Title: Towards effective capacity planning in a perinatal network centre
Citation: Archives of Disease in Childhood: Fetal and Neonatal Edition, July 2010, vol./is.
95/4(F283-F287), 1359-2998;1468-2052 (July 2010) Author(s): Asaduzzaman Md.,
Chaussalet T.J., Adeyemi S., Chahed S., Hawdon J., Wood D., Robertson N.J.
Abstract: To study the arrival pattern and length of stay (LoS) in a neonatal intensive
care/high dependency unit (NICU/HDU) and special care baby unit (SCBU) and the impact
of capacity shortage in a perinatal network centre, and to provide an analytical model for
improving capacity planning. Full Text: Available in fulltext at Highwire Press
Title: Critical path network. Bed capacity project reduces discharge, ED delays
Citation: Hospital case management : the monthly update on hospital-based care planning
and critical paths, July 2010, vol./is. 18/7(103-105), 1087-0652 (Jul 2010) Full Text:
Available in fulltext at EBSCO Host Available in fulltext at ProQuest (Legacy Platform)
Discharge coordination
Title: Standardizing hospital discharge planning at the Mayo Clinic.
Citation: Joint Commission Journal on Quality & Patient Safety, 01 January 2011,
vol./is. 37/1(29-36), Author(s): Holland, Diane E., Hemann, Michele A.
Abstract: Improving the quality of patient coordination in the transition from hospital to home
is a high-priority health care concern. The successes of the standardization of DP processes
and improved multidisciplinary teamwork were important considerations for implementation
throughout the organization.
Discharge process
Rapid Impact Assessment of The Productive Ward: Releasing time to care
Based on in-depth case studies conducted with acute trusts in England, the Rapid Impact
Assessment explores the efficiency and productivity improvements the programme can
make across the NHS NHS England by 2014.
Download the results as an Executive Summary ( 183.70 KB) or full report ( 2.41 MB).
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Title: An integrated review of the literature on challenges confronting the acute care staff
nurse in discharge planning.
Citation: Journal of Clinical Nursing, 01 March 2011, vol./is. 20/5/6(754-774), 09621067
Author(s): Nosbusch, Jane M, Weiss, Marianne E, Bobay, Kathleen L
Abstract: This integrative review presents and synthesises previous research investigating
practices, perceptions and experiences of bedside staff nurses relative to hospital discharge
planning.
Title: A unit-coordinator system: an effective method of reducing inappropriate hospital
stays.
Citation: Int Nursing Review, March 2011, vol./is. 58/1(96-102), 0020-8132 (2011 Mar)
Author(s): Yu, S, Ko, I, Lee, S
Abstract: Research in Korea into the effectiveness of a unit-coordinator system combined
with primary nursing as a way of reducing inappropriate hospital stays.
Title: The high impact actions for nursing and midwifery 8: ready to go -- no delays... last in
our series.
Citation: Nursing Times, 31 August 2010, vol./is. 106/34(16-17), 09547762 Author(s):
Ward L, Fenton K, Maher L
Abstract: This article, the last in our series on the high impact actions for nursing and
midwifery, looks at how nursing staff can respond to the issue of discharge planning. Full
Text: Available in fulltext at Ovid
Title: Case management accountability for safe, smooth, and sustained transitions: a plea
for building "wrap-around" case management services now.
Citation: Professional Case Management, 01 July 2010, vol./is. 15/4(188-201), 19328087
Author(s): Zander K Abstract: The purpose is to encourage hospital administrations to
address readmissions immediately and to restructure and significantly enhance case
management services once and for all so that they can provide a "wraparound" service for
the full clinical course from admission to transition for all patients and families.
Education and Practice
Title: Developing discharge practice through education: module development, delivery and
outcomes.
Citation: Nurse Education in Practice, 01 July 2010, vol./is. 10/4(210-215), 14715953
Author(s): Lees L, Price D, Andrews A
Abstract: To support nurses in practice a part time, post registration discharge practice
education module was developed entitled Facilitating Timely Patient Discharge. It was the
first of its kind to be accredited at degree level (level 6) during 2006. University evaluation of
the module involved an academic assignment based on a 3000 word case study. Projects in
practice were integrated to enable the students to apply theories to clinical practice. This
aspect was driven by an organisational impetus to demonstrate learning back in practice to
the benefit of Heart of England Foundation Trust (HEFT). Full Text: Available in fulltext at
Elsevier; Note: You will need to register (free of charge) with Science Direct the first time you
use it.
Estimating dates for discharge
Title: Patient recovery scheme cuts hospital stay in half.
Citation: Nursing Times, April 2010, vol./is. 106/15(1), 0954-7762 (2010 20 Apr) Author(s):
Santry, C
Abstract: Report of a scheme to improve postoperative care and reduce time spent in
hospital. The nurse-led enhanced recovery model, which involves hospital nurses rather
than GPs monitoring patients after discharge, is described and the benefits for costs and
patient care are discussed. Full Text: Available in fulltext at Ovid
Title: The enhanced recovery programme for stoma patients: an audit.
Citation: Br J Nursing, July 2010, vol./is. 19/13(831-4), 0966-0461 (2010 8 Jul) Author(s):
Bryan, S, Dukes, S
Abstract: Audit of the enhanced recovery programme used by a multidisciplinary team in a
Salisbury hospital for patients undergoing colorectal surgery with a stoma, to reduce the time
before discharge. Education for practice change, patient support and audit procedures for 60
patients are described and discharge times and patient satisfaction are considered. Full
Text: Available in fulltext at EBSCO Host
Title: Patient recovery scheme cuts hospital stay in half.
Citation: Nursing Times, April 2010, vol./is. 106/15(1), 0954-7762 (2010 20 Apr) Author(s):
Santry, C
Abstract: Report of a scheme to improve postoperative care and reduce time spent in
hospital. The nurse-led enhanced recovery model, which involves hospital nurses rather
than GPs monitoring patients after discharge, is described and the benefits for costs and
patient care are discussed. Full Text: Available in fulltext at Ovid
Multidisciplinary team discharges
Title: A cure for bed blocking.
Citation: Community Care, February 2011(22-4), 0307-5508 (2011 10 Feb) Author(s):
Dunning, J
Abstract: How joint working between health and social care services in Portsmouth has
reduced hospital discharge delays. Full Text: Available in fulltext at EBSCO Host
Title: Introduction of a multidisciplinary discharge planning meeting in the inpatient oncology
unit at Maroondah hospital
Citation: Asia-Pacific Journal of Clinical Oncology, November 2010, vol./is. 6/(190), 1743-
7555 (November 2010) Author(s): Birkenfelds A., Arnold M. Abstract: It was anticipated
that the introduction of a dedicated oncology multidisciplinary discharge planning meeting
(MDPM) would support patient discharge documentation, improve timeliness of inpatient
allied health referrals and reduce patient length of stay (LOS).
Title: Discharge plan reduces LOS for long-stay patients.
Citation: Hospital Case Management, 01 April 2010, vol./is. 18/4(54-56), 10870652
Abstract: Planning starts early after admission.
Full Text: Available in fulltext at EBSCO Host Available in fulltext at ProQuest (Legacy
Platform)
Nurse-led discharge
Title: Nurse-led discharge.
Citation: Nursing Management UK, December 2010, vol./is. 17/8(26-7), 1354-5760 (2010
Dec) Author(s): Page, C Abstract: The advantages of a nurse-led discharge process. The
development and introduction of a nurse-led discharge process in the ambulatory care unit
at Milton Keynes Hospital are described, and the extended role of the nurses in the unit is
discussed. The benefits, including a reduction in costs and an improved patient experience,
are highlighted. Full Text: Available in fulltext at EBSCO Host Available in fulltext at EBSCO
Host Available in fulltext at ProQuest (Legacy Platform)
Title: Evaluation of the transitional care model in chronic heart failure.
Citation: Br J Nursing, December 2010, vol./is. 19/22(1402-7), 0966-0461 (2010 9 Dec)
Author(s): Williams, G, Akroyd, K, Burke, L Abstract: Research into the effect of a nurse-
led transitional care service on readmissions in patients with chronic heart failure. The
intervention is described and readmission rates, length of stay and patient satisfaction with
care and information provided are considered. Full Text: Available in fulltext at EBSCO
Host
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Title: Health-related quality of life in patients undergoing peritoneal dialysis: effects of a
nurse-led case management programme.
Citation: J Advanced Nursing, August 2010, vol./is. 66/8(1780-92), 0309-2402 (2010 Aug)
Author(s): Chow, S, Wong, F Abstract: Research by randomised controlled trial in Hong
Kong to evaluate use of case management programme in improving quality of life for
peritoneal dialysis patients. The nurse-led programme involving a discharge plan,
predischarge comprehensive assessment, patient education and motivational interview is
described, including the 6-week nurse-initiated telephone intervention. Quality of life
assessments at regular intervals in the programme are reported. Full Text: Available in
fulltext at Ovid
Title: High impact actions: discharge planning.
Citation: Nursing Management UK, June 2010, vol./is. 17/3(12-6), 1354-5760 (2010 Jun)
Author(s): Wagstaff, N, Butler, J, Kalanovic, S
Abstract: 1st in a series on the NHS Institute for Innovation and Improvement publication
'High Impact Actions for Nursing and Midwifery', focusing on nurse-led initiatives that have
improved patient discharge arrangements. Senior nurses from Homerton University Hospital,
London, Stockport NHS Foundation Trust and Calderdale and Huddersfield NHS Foundation
Trust describe how delays and lengths of stay in hospital have been reduced. 5 refs.
Full Text: Available in fulltext at EBSCO Host Available in fulltext at EBSCO Host Available
in fulltext at ProQuest (Legacy Platform)
Patient centred discharges
Title: Patients' perceptions of early supported discharge for chronic obstructive pulmonary
disease: a qualitative study.
Citation: Quality & Safety in Health Care, 01 April 2010, vol./is. 19/2(95-98), 14753898
Author(s): Clarke A, Sohanpal R, Wilson G, Taylor S Abstract: To explore patients' views
of an early supported discharge service for chronic obstructive pulmonary disease (COPD).
Simple discharges and complex discharges
Title: Creating an agreed discharge: discharge planning for clients with high care needs.
Citation: J Clinical Nursing, February 2011, vol./is. 20/3-4(444-53), 0962-1067 (2011 Feb)
Author(s): Tomura, H, Yamamoto-Mitani, N, Nagata, S
Abstract: Qualitative research in Japan examining discharge nurses' experiences of
planning the hospital discharge of a patient with acute care requirements.
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Title: Supporting patients with enterocutaneous fistula: from hospital to home.
Citation: Br J Community Nursing, February 2011, vol./is. 16/2(66-73), 1462-4753 (2011
Feb) Author(s): Slater, R Abstract: Discussion of the management of patients with
enterocutaneous fistula (ECF) who require long-term care in the community. Full Text:
Available in fulltext at EBSCO Host
Title: Why do patients with complex palliative care needs experience delayed hospital
discharge?
Citation: Nursing Times, June 2010, vol./is. 106/25(15-7), 0954-7762 (2010 29 Jun)
Author(s): Thomas, C, Ramcharan, A
Abstract: Clinical audit of discharge delays experienced by palliative care patients with
complex needs. Length of time between proposed and actual date of discharge was also
determined and recommendations for improvements are made. Full Text: Available in
fulltext at Ovid
Title: A unit-localized hospitalist system and its impact on patients requiring complex
discharge planning
Citation: Journal of General Internal Medicine, June 2010, vol./is. 25/(S216), 0884-8734
(June 2010) Author(s): Shaines M., Southern W.
Abstract: A unit-localized hospitalist system had no overall effect on a patient's discharge
time of day or LOS, but did significantly impact LOS in those patients with the most complex
discharge planning.
Title: Dealing with short discharge opportunities.
Citation: Healthcare Benchmarks & Quality Improvement, 01 June 2010, vol./is.
17/6(66-68), 15411052 Full Text: Available in fulltext at EBSCO Host Available in fulltext at
ProQuest (Legacy Platform)
NB: Multiple sources – websites, journals and healthcare databases – have been searched
for evidence published in the last one year i.e. April 2010 – April 2011 are identified and
highlighted here. For a detailed list of sources that have been scanned, please contact
For more information on how to register for Athens, access the Athens Registration leaflet
via HEFT Library website www.heftlibrary.nhs.uk
Produced with support from Liz Lees, Consultant Nurse, Acute Medicine.