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

Abstract

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.

Clinical Implications of a Moderate Positive Correlation Between the Braden Score and the AM-PAC Basic Mobility Score in the Acute Care Setting

“…The Braden and the AM-PAC have the ability to work in combination to determine a patient's current burden of care, when services are needed to minimize delays in discharge, and to identify a decline in patient function. Although continued self-education and use of critical thinking should be a regular part of hospital staff practice, 13 knowledge of the Braden scoring system and its relationship to the AM-PAC may help to allocate physical therapy and other hospital resources, more efficiently. Rehabilitation departments could use the Braden score to help determine hospital areas with greater mobility needs and work to better distribute staffing levels accordingly.…”