Validating Performance of a Hospital Discharge Planning Decision Tool in Community Hospitals

Holland, Diane E.; Brandt, Cheryl; Targonski, Paul V.; Bowles, Kathryn H.

doi:10.1097/ncm.0000000000000233

Cited by 8 publications

(23 citation statements)

References 21 publications

(26 reference statements)

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“…Seven articles, all of which reported studies that evaluated the ESDP tool's use for adults, remained and were included in this literature review. 14,[17][18][19][20][21][22] Results from the critical appraisal of the included studies' methodological quality using the CASP Checklist for Cohort Studies are shown in Table 2. Using the planned quality rating approach, 5 studies 14,[17][18][19][20] were rated as being of "good" methodological quality, and 2 studies 21,22 were rated as "fair.…”

Section: Methodsmentioning

confidence: 99%

“…A primary limitation noted across the 7 included studies was a lack of population diversity. 14,[17][18][19][20][21][22] Four of the included studies reported on participant race, 17,[19][20][21] and in those studies, the proportions of participants who were categorized as White ranged from 76.7% to 99.5%. Other reported race categories included African American/Black (0.83%-14%), Hispanic (0.83%-1.3%), and other (2.55%-9.3%), with each of these race categories representing less than 14% of participants in any 1 of the 4 studies.…”

Section: Methodsmentioning

confidence: 99%

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The Utility of Mayo Clinic's Early Screen for Discharge Planning (ESDP) Tool: A Critical Narrative Review

Socwell

Kanagasaba

Pope

2021

Journal of Acute Care Physical Therapy

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Purpose: The aim of this critical narrative review was to identify and synthesize available research evidence on the utility of Mayo Clinic's Early Screen for Discharge Planning (ESDP) tool to (1) identify adult patients early during their hospital stay who require referral to specialized hospital discharge planning services (SHDCPS) and (2) review its utility in predicting patient outcomes including hospital length of stay (LOS), readmission risk, and discharge destination. This review also begins by highlighting the important role of physical therapists in discharge planning. Methods: A critical narrative review was conducted of relevant studies identified through a systematic search of PubMed, CINAHL, Embase, and ProQuest databases and subsequent systematic screening and selection process. Studies were included and critically appraised if they met eligibility criteria: studies investigating the development, predictive validity and utility of the ESDP in hospital patient populations, and studies comparing the ESDP with other discharge planning tools. Key data were then extracted and tabulated before a critical narrative synthesis of key findings was completed. Results: Seven studies met the eligibility criteria, with 5 studies receiving a rating of "good" quality. The included studies investigated the ESDP tool in adults within acute inpatient hospital settings, including heart failure, colorectal surgery, general medical and surgical, and oncology wards. Conclusion: Five of the 7 included studies were of good quality and, together, studies provided evidence that the ESDP tool correctly identifies adults requiring referral to SHDCPS. However, further research of the ESDP tool is recommended to account for variations observed in special populations and expand knowledge of its utility to predict outcomes such as hospital LOS, readmission risk, and discharge destination.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

The Utility of Mayo Clinic's Early Screen for Discharge Planning (ESDP) Tool: A Critical Narrative Review

Socwell

Kanagasaba

Pope

2021

Journal of Acute Care Physical Therapy

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“…Holland et al showed that older age, walking limitation, living alone before admission, and the level of disability indicate the need for a specialized discharge planning team in surgery units. 8,[29][30][31] A specialized discharge planning team may also be of value in the management of cancer patients. 7 Indeed, discharge is often delayed by the lack of a suitable care facility.…”

Section: Benefits and Tools For Discharge Planning Teamsmentioning

confidence: 99%

“…4,5 Studies of surgical and neurology wards have shown that older age and poor functional independence are risk factors for transfer to PAC. [6][7][8][9] Specific tools [7][8][9][10] have been developed to identify patients at risk of transfer to PAC and it has been shown that the use of some of these tools is associated with a shorter length of hospital stay. 9,11 Acute geriatric units (AGUs) provide specific care for frail, dependent or multimorbid older adults with acute health problems.…”

Section: Introductionmentioning

confidence: 99%

Factors Associated with Transfer from an Acute Geriatric Unit to a Post-Acute Care Facility among Community-Dwelling Patients: Results from the DAMAGE Cohort

Deschasse¹,

Drumez²,

Visade³

et al. 2022

CIA

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Background Acute geriatric units (AGUs) require efficient discharge planning tools. Risk factors for discharge from an AGU to post-acute care (PAC) have not previously been investigated in detail. Methods The objective is to identify risk factors for PAC transfer. The DAMAGE (prospective multicenter cohort) consecutively included more than 3500 subjects aged 75 or older and admitted to an AGU. The patients underwent a comprehensive geriatric assessment (CGA) during their stay in the AGU. Only community-dwelling patients admitted to the AGU from the emergency department were included in the analysis. We recorded the characteristics of the care pathway and identified risk factors for discharge to home or to a PAC facility. Results 1928 patients were included. Loss of functional independence (a decrease in the Katz activities of daily living (ADL) score between 1 month prior to admission and AGU admission), living alone, social isolation, a high Katz ADL score at home, a low Katz ADL on admission, and delirium on admission were risk factors for transfer to PAC. Obesity, an elevated serum albumin level, and community-acquired infection were associated with discharge to home. Neither sex nor age was a risk factor for home discharge or transfer to PAC. Conclusion The present results might help clinicians and discharge planning teams to identify patients at risk of transfer to PAC more reliably and promptly in AGUs.

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“…In order to facilitate and improve the discharge process and to prevent undesirable outcomes, different interventions involving ICT solutions have been developed over the years. Different decision-supportive tools [ 9 , 10 ], tailormade discharge models and structured discharge summaries [ 11 – 13 ] have been tested with various results. A review of statistics published between 1999 and 2016 show that 7–89% of the ICT projects in different sectors failed because they did not meet one or more of three basic criteria: finishing on time, finishing within budget, and achieving satisfactory results [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

“It’s all about time and timing”: nursing staffs’ experiences with an agile development process, from its initial requirements to the deployment of its outcome of ICT solutions to support discharge planning

Nordmark

Lindberg

Zingmark

2022

BMC Med Inform Decis Mak

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Background Agile projects are statistically more likely to succeed then waterfall projects. The overall aim of this study was to explore the nursing staffs’ experiences with an agile development process, from its initial requirements to the deployment of its outcome of ICT solutions aimed at supporting discharge planning. Methods An explorative design with quantitative and qualitative methods was used. Qualitative data was collected through seven focus group interviews. Quantitative data was collected via an ICT-system, and with an evaluation form submitted by fourteen registered nurses and nine district nurses. Results Qualitative result of the experiences with the agile development process and its outcome resulted in one theme, four categories, and ten subcategories. The theme was found to be about time and timing, namely the amount of time for the different activities and the timing of activities within and between organisations. The agile development process increased the participants’ readiness for change by offering time to learn, practice, engage and reflect, and then adopt the ICT as a support to daily practice. Quantitative results showed a variated adoption of the ICT. Conclusion There is a need for time to prepare, understand and adopt new tools, services and procedures and a need for additional time to prepare, understand and adopt the new among individuals, collectives, organizations, and sometimes even between different collectives or organizations. The agile development process offered the end-users involvement through the development process, which gave them time to change it both individually and collectively. However, there is a need for close collaboration between the development project team and management to reach an organizational change that is timely for both the individual and the collective change. When time or timing fails in the development or implementation process, there is a huge risk of non-adoption of new tools, services, or procedures or among the end-users.

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Validating Performance of a Hospital Discharge Planning Decision Tool in Community Hospitals

Cited by 8 publications

References 21 publications

The Utility of Mayo Clinic's Early Screen for Discharge Planning (ESDP) Tool: A Critical Narrative Review

The Utility of Mayo Clinic's Early Screen for Discharge Planning (ESDP) Tool: A Critical Narrative Review

Factors Associated with Transfer from an Acute Geriatric Unit to a Post-Acute Care Facility among Community-Dwelling Patients: Results from the DAMAGE Cohort

“It’s all about time and timing”: nursing staffs’ experiences with an agile development process, from its initial requirements to the deployment of its outcome of ICT solutions to support discharge planning

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