Patients’ readiness for discharge: Predictors and effects on unplanned readmissions, emergency department visits and death

Abstract

Nurse managers can consider the predictors of patients' readiness for discharge, thus the risk of unplanned readmission and death may be reduced.

Safe to send home? Discharge risk assessment in the emergency department

“…33 However, Lowthian et al in an Australian cohort study found that those who lived alone were not more likely to return to the ED at 30 days. A Turkish study found that living alone increased sevenfold the rate of ED returns at 30 days.…”

“…A Turkish study found that living alone increased sevenfold the rate of ED returns at 30 days. 33 However, Lowthian et al in an Australian cohort study found that those who lived alone were not more likely to return to the ED at 30 days. 34 Differences between studies can be related to access to care and community resources; in the Australian cohort, 97% had a general practitioner.…”

“…In an inpatient study, patients who did not feel ready for discharge were 70% more likely to have ED revisits, death, or an unplanned readmission by 30 days. 33 Additionally, the nurse's perception of whether the patient was ready for discharge can be even more predictive than the patient's perception. 36 This has not been investigated in the ED but a discussion with the patient about their readiness and comfort with discharge gives the patient the opportunity to bring up some of the issues listed in Table 1 without using formal assessments.…”

Discharge Teaching to Improve Discharge Readiness for Patients Post Hip Surgery

“…The condition of unpreparedness of the patient's return will have an impact on the status of the patient after returning including having a high average length of stay, i.e., the patient is treated three days longer than the patient who is prepared (9). Patient characteristics and lack of discharge readiness were assessed to be associated with reduced hospital discharge conditions (10).…”

“…Discharge readiness is an indicator to determine the preparation process for return and gives an influence on the risk of readmission (11). Unpreparedness to go home will also increase visits to the Emergency Room (ED), the incidence of unplanned readmission, and the risk of death after 30 days of discharge from the hospital (9). Every 1% increase in readmission in postoperative patients with THA provides an increase in the cost of health care costs by 1.8% (12).…”