DNP project: Implementation of the IDEAL discharge checklist in the acute care setting

Purpose: The purpose of this Doctor of Nursing Practice (DNP) quality improvement project was to evaluate whether implementation of the IDEAL discharge checklist reduced 30-day readmissions among older adults on a 39-bed medical/neurology unit in a community hospital.Methods: Guided by the Plan-Do-Study-Act (PDSA) framework, case managers were trained to distribute the IDEAL “Be Prepared to Go Home” booklet, and nurses reinforced medication education, engaged caregivers, and supported follow-up planning. Over a six-week period, 113 patients met eligibility criteria, with 106 included in the final analysis. Twenty-four patients (22.6%) received the IDEAL booklet, while 82 did not.Results: Baseline Medicare data from June 2024 showed a 30-day readmission rate of 15.71% (11/70). During implementation, readmissions occurred in 33.3% (8/24) of booklet recipients and19.5% (16/82) of non-recipients. These results likely reflect the small sample size, selection of higher-risk patients, and inconsistent application of checklist elements.Implications: Although the project did not demonstrate a reduction in readmissions, it identified barriers to implementation and highlighted the need for electronic health record integration, staff accountability, and targeted strategies for high-risk populations. Sustained use of IDEAL has the potential to strengthen patient and family engagement in discharge planning and improve care transitions.