A standardized discharge planning curriculum for medicine interns increased the reported frequency of completing 4 of 5 key discharge tasks compared to experienced control interns.
Cohort
Does a standardized discharge planning curriculum improve medicine interns' confidence and frequency of completing discharge tasks compared to experienced interns from the previous year?
A standardized discharge planning curriculum for medicine interns increased the self-reported frequency of completing key discharge tasks but did not affect clinical outcomes such as hospital readmissions.
OBJECTIVES: Hospital discharge is a challenging time for residents, requiring the completion of many tasks to ensure safe transitions for patients. Despite recognition of the importance of hospital discharge planning, formal curricula are lacking. We sought to improve medicine residents' comfort and skills with discharge planning and enhance the quality of care by introducing a standardized approach to discharge on the medicine wards. METHODS: The intervention included a didactic, a bedside rounds component, and a discharge checklist. Interns were surveyed at the end of rotations to measure confidence, attitudes, and frequency of completing discharge planning tasks. Results were compared with a control group of experienced interns from the previous academic year. Clinical outcomes included hospital readmission and emergency department return rates and patient satisfaction scores in discharge-related domains. RESULTS: Study interns reported similar confidence to control group interns with discharge planning and endorsed completing four of five discharge tasks more frequently than control interns. There were no differences in clinical outcomes. CONCLUSIONS: We did not identify changes in clinical outcomes, although this finding likely reflects the multifactorial nature of hospital readmissions. Interns exposed to the curriculum early in the academic year had a higher reported frequency of completing key discharge tasks and similar confidence around discharge, when compared with end-of-the-year interns. These improvements suggest that the curriculum led to a change in culture surrounding discharge planning and perhaps accelerated learning of skills associated with discharge best practices.
Eden et al. (Sat,) conducted a cohort in Hospital discharge planning. Standardized discharge planning curriculum (didactic, bedside rounds, checklist) vs. Experienced interns from the previous academic year was evaluated on Confidence, attitudes, and frequency of completing discharge planning tasks, and clinical outcomes (readmission, ED return, patient satisfaction). A standardized discharge planning curriculum for medicine interns increased the reported frequency of completing 4 of 5 key discharge tasks compared to experienced control interns.