Increasing Patient Satisfaction During the Discharge Process

Purpose:
In 2010 HCAHPS scores reflected a low level of patient satisfaction regarding quality of the hospital discharge process. The goal of this initiative was to increase patient satisfaction with education and discharge. Success would be measured by improving scores on question 20 from 76% to 85%.

Significance:
An ineffective discharge leads to decreased medical compliance, poor clinical outcomes, increased hospital readmissions and increased hospital costs. Development of an individualized discharge plan for the patient prior to leaving the hospital controls costs and improves patient outcomes.

Strategy and Implementation:
The quality improvement initiative included two process changes on the unit. The first process change was an interdisciplinary approach that included all patients to receive a discharge education folder upon admission to the unit. The second process change included a selected patient population to receive follow up correspondence from the nursing leadership team reviewing important discharge information and contact information for follow up concerns. These patient quality improvements were embraced by the units' nursing leadership team and management to encourage buy-in from staff and other disciplines. Compliance rounding was completed by leadership daily to ensure that patients had their education folders available to them. The units' Patient Care Leaders tracked the specified patient populations and obtained verbal consent for follow up management and correspondence.

Evaluation:
A review of question 20 HCAHPS scores prior to project implementation (2009) demonstrated an average satisfaction score of 75.68%. After project implementation annual scores confirmed improved satisfaction, with 2010 averaging 81.32%, 2011 averaging 85.56% and year to date 87.50 %.

Implications for Practice:
Improved scores show enhanced communication and education with patient's disease processes, recovery and risk factor modification. Through effective and purposeful education patients engage in their disease and symptom management thus improving overall health and decreasing hospital readmission.