Objective. To validate patient and nurse short forms for discharge readiness assessment and their associations with 30-day readmissions and emergency department (ED) visits. Data Sources/Study Setting. A total of 254 adult medical-surgical patients and their discharging nurses from an Eastern US tertiary hospital between May and November, 2011. Study Design. Prospective longitudinal design, multinomial logistic regression analysis. Data Collection/Extraction Methods. Nurses and patients independently completed an eight-item Readiness for Hospital Discharge Scale on the day of discharge. Patient characteristics, readmissions, and ED visits were electronically abstracted. Principal Findings. Nurse assessment of low discharge readiness was associated with a six-to nine-fold increase in readmission risk. Patient self-assessment was not associated with readmission; neither was associated with ED visits. Conclusions. Nurse discharge readiness assessment should be added to existing strategies for identifying readmission risk.

Postdischarge utilization costs could potentially be reduced by investment in nursing care hours to better prepare patients before hospital discharge.

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It is expected that understanding the nature, as well as the key elements of the concept, would assist with analysing the existing safety culture and help to determine the strategies to build or shape the safety culture.