Discharge Planning- May 2011


Discharge Planning Evidence Update



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



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



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).


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



Title:  A  unit-coordinator  system:  an  effective method   of  reducing  inappropriate  hospital


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


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



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



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.


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


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

[email protected]



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.