EXAMINING THE DISCHARGE PLANNING PROCESS: AN EVALUATION OF TWO MODELS IN AN ACUTE CARE COMMUNITY HOSPITAL (HOSPITAL).
Contributors: Johns Hopkins University, School Of Public Health And Hygiene.
Published: 1984
Number of pages: 217
Subjects: Health Sciences, Nursing.; Health Sciences, Public Health.; Health Sciences, Health Care Management.
Description: Utilizing an experimental cross-over design, two models of discharge planning were tested in an acute care community teaching hospital. Comparisons of their effects on the processes and outcomes of health care were made.

The study was carried out at weekly interdisciplinary continuity of care rounds on six medical and/or surgical units on two sides of a 355 bed hospital. Patients with the diagnostic categories of cancer, diabetes, diseases of the blood vessels, heart, respiratory system and chronic renal failure were included. The three phases of the study were baseline and a two wave cross-over with the experimental and control groups randomized.

Sociodemographic, social support, economic and previous hospital utilization data were obtained and their effect upon the dependent variables examined. The independent and dependent variables were based on the broad framework of structure affecting process and process affecting outcome. The major independent variable was the structural change in the composition of the rounds team with a variation in size from six to three providers. The dependent variables were the process variables of probing, identifying, planning and following through on patient discharge needs. Other dependent variables were the outcome variables: referrals to agencies, length of stay and utilization of services post-discharge.

The methods for collecting the data were observing and tape recording the rounds using a structured instrument to capture the dependent process variables, and chart review. The data were analyzed using the chi-square test of significance, two-tailed t-test for independent groups and two-way analysis of variance for a cross-over design.

Essentially no differences were found between the groups. It seems that for optimum utilization of resources, the rounds team could be three providers. However, low levels of discharge planning for both groups raise questions regarding quality. This study has implications from administrative, educational and clinical perspectives.
Notes: Source: Dissertation Abstracts International, Volume: 50-12, Section: B, page: 5549.

Thesis (DR.P.H.)--THE JOHNS HOPKINS UNIVERSITY, SCHOOL OF PUBLIC HEALTH AND HYGIENE, 1984.

School code: 1046.