Discharge Information, Does it Really Start on Admission?

Purpose:
The purpose of this presentation is to share how one hospital led the way, through an interdisciplinary team, to improve the quality of discharge information we provide to our patients.

Significance:
While not captured in NDNQI indicators, Value-Based Purchasing will change the way acute care hospitals are paid. No longer will reimbursement be based on the care delivered but rather on the quality and patient satisfaction outcomes of that care.

Strategy and Implementation:
To develop the innovation, front-line staff evaluated the current process, identified inconsistencies, and reviewed best practice. Using Lean Six Sigma principles we re-tooled the process to 1) deploy discharge education materials to the point of service, 2) engage all staff to educate, regardless of position, and to 3) celebrate individual and unit successes when key benchmarks were obtained. The team developed a 9 x 12 discharge envelope to provide general discharge planning instructions and store education materials, unit specific discharge instructions, and diet restriction education. The envelopes were stuffed by a volunteer, stocked on the supply cart, and placed at the bedside during room set-up. On admission, the professional nurse reviewed key components of the discharge materials and added individualize written discharge information over time. One week after discharge, the Quality of Discharge Teaching Scale was used to evaluate the immediate effect of the initiative.

Evaluation:
Call backs indicate that the discharge education quality significantly improved (t=4.479; p < .001) with an overall improvement of HCAHPS Discharge Information variable increasing from the 34th to 61st percentile over a 3 month period.

Implications for Practice:
Our process can be replicated to efficiently and cost effectively improve the quality of the discharge information provided while increasing your HCAHPS percentile ranking. All nurses say: “Patient education begins on admission”, by duplicating our initiative you can proudly say...It DOES!!!!!