Demystifying the Discharge Process

In an effort to increase our overall patient satisfaction scores or, more specifically, the questions related to patients understanding their responsibilities after discharge related to their care, a patient satisfaction task force was developed. The task force consisted of the members of the unit-based council, leadership team, a quality improvement advisor, a patient experience specialist, and attending physicians. Data was gathered from a discharge phone call trial, as well as feedback from clinic follow-ups. Currently, the discharge paperwork is lengthy and contains a considerable amount of information, which is important, but can be overwhelming to patients.

A discharge checklist titled “Patient Management of Care at Home” was created to accompany the current discharge paperwork that is given to patients. This one-page checklist highlights their activity level, diet, care of their surgical incisions, and how to contact their surgeon. Once the checklist was drafted, it was taken to the hospital’s patient and family advisory council – a group of individuals consisting of previous patients from the hospital as well as family members of patients – to gain input. The document was revised to ensure the language was at a basic reading level and was then implemented on the unit.

The organization utilizes an external vendor to send patient satisfaction surveys and collect data received from those surveys. To measure the effectiveness of the discharge checklist, several questions from our Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) questions were selected to measure success. Specifically, the HCAHPS questions “talked about help you would need” and “understood managing of health.” At the start of this project, the unit scored 79.3 percent positive on “talked about help you would need” compared to the benchmarked average of 85.5 percent, and 48.4 percent positive on “understood managing of health” compared to the benchmarked average of 53.5 percent.

Following the first quarter since implementation, a difference in the unit’s patient satisfaction scores was observed. The “talked about help you would need” question score increased to an average of 88.5 percent positive, with one month scoring a 90.5 percent. The “understood managing of health” question score increased to an average of 57.5 percent positive, with one month scoring a 62.1 percent. Both of these scores are now above the benchmarked average for positive responses. Implementation of the discharge checklist has continued to show an improvement in the unit’s patient satisfaction scores, specifically related to our key driver questions. Success was presented to the adult acute care division, composed of five acute care units. Each unit tailored the checklist to meet the needs of their specific patient populations. Clarifying the discharge process has led to a safer discharge process and improved overall communication.