Models of Discharge Care in Magnet® Hospitals

J Nurs Adm. 2015 Oct;45(10):485-91. doi: 10.1097/NNA.0000000000000239.

Abstract

Objective: The aim of this article is to describe how the discharge preparation process is operationalized in Magnet® hospitals.

Background: Nationally, there are intensive efforts toward improving discharge transitions and reducing readmissions. Discharge preparation is a core hospital function, yet there are few reports of operational models.

Methods: This was a descriptive, Web-based survey of 32 Magnet hospitals (64 units) participating in the Readiness Evaluation and Discharge Interventions study.

Results: Most hospitals have adopted 1 or more national readmission reduction initiatives. Most unit models include several discharge preparation roles; RN case managers, and discharging RNs lead the process. Nearly one-half of units actively screen for readmission risk. More than three-fourths report daily discharge rounds, but less than one-third include the patient and family. More than two-thirds report a follow-up phone call, mostly to assess patient satisfaction.

Conclusions: Magnet hospitals operationalize discharge preparation differently. Recommended practices from national discharge initiatives are inconsistently used. RNs play a central role in discharge planning, coordination, and teaching.

MeSH terms

  • Cross-Sectional Studies
  • Guidelines as Topic
  • Health Care Surveys
  • Hospital Administration / methods
  • Hospital Administration / standards*
  • Hospitals / classification
  • Humans
  • Models, Organizational
  • Multicenter Studies as Topic
  • Nurse's Role
  • Patient Discharge / standards*
  • Patient Discharge / statistics & numerical data
  • Patient Education as Topic / methods
  • Patient Education as Topic / standards*
  • Patient Readmission / standards*
  • Patient Readmission / statistics & numerical data