Characteristics of effective discharge planning programs: The nursing administration perspective

The purpose of this study was to examine discharge planning programs in terms of management and nursing/patient outcomes to generate information regarding the optimum design of discharge planning programs for use in decision making by nursing administrators.; The independent variables in the study were the structure and process of discharge planning and the dependent variables were the management outcomes (length of stay and readmission rate) and the nursing/patient outcomes (provision of post-discharge services and patient satisfaction).; The population consisted of hospitalized patients from community hospitals, age 70 years and older. Patients who agreed to participate in the study were assessed for functional status while in the hospital and contacted by phone two weeks post-discharge to complete an interview evaluating the patient's satisfaction with the discharge planning process and the provision of services. Information regarding length of stay and readmission was collected from the patient's medical record. The Long-Term Care Information System Assessment Process (Falcone, 1979) was used to evaluate the functional assessment information for post-discharge needs. Ordered post-discharge services were identified from retrospective chart review.; The design was descriptive, correlational. Data analysis consisted of frequencies, ANOVA, and chi-square analyses. The discharge planning programs with a high degree of structure formality revealed a positive association with increased provision of post-discharge services (.03) and higher patient satisfaction (.01). Reduced LOS showed some association with the more highly formalized structure (.09). Chi-square analyses revealed positive associations between the individual structure components, admission assessment and follow-up programs, and increased patient satisfaction. Process was not significantly associated with any of the independent variables.; The findings support the use of a highly formalized discharge planning program for quality nursing outcomes and to a lesser degree for the management outcomes. Further research is needed to investigate the importance of the individual components which comprise the formal design. Other research is also indicated to test and develop the nursing administration conceptual framework proposed by Scalzi & Anderson (in press).