Key result
The total number of patient-reported barriers to discharge decreased by an average of 0.15 per day (95% CI 0.01-0.30; P=0.047), yet 90% of patients were discharged with at least one barrier.
Why the study?
What is the prevalence and resolution rate of patient-reported barriers to discharge during hospitalization?
Observational (n=163)
No
What is the prevalence and resolution rate of patient-reported barriers to discharge during hospitalization?
Mean Difference: 0.15 (95% CI 0.01–0.3)
p-value: p=0.047
Patient-reported barriers to discharge are highly prevalent and often remain unresolved at the time of discharge, highlighting a need for improved discharge planning.
Barriers persist at discharge despite modest daily decline; hypothesis-generating for targeted interventions before practice change.
BACKGROUND: Planning for discharge from the hospital should begin early in each patient's stay and focus on the patient's needs. OBJECTIVE: To determine how often patient-reported barriers to discharge on admission were resolved by discharge and to explore associations between barriers and readmission. DESIGN, SETTING, AND PARTICIPANTS: A prospective observational study of patients admitted to an academic medical center. INTERVENTION AND MEASUREMENTS: Patients completed a barriers to discharge survey from the start of hospitalization to discharge. Primary outcomes were the prevalence of discharge barriers, rates of resolution of barriers during hospitalization, and comparisons between barriers identified in admission and discharge surveys. RESULTS: One hundred sixty-three patients were enrolled, and 68 patients (42%) completed an admission survey and discharge survey ≤48 hours before discharge. Patients completed on average 1.82 surveys (standard deviation, 1.10; range, 1-8). Total and mean numbers of barriers were highest on the admission survey and decreased until the fourth survey. On average, the total number of barriers to discharge decreased by 0.15 (95% confidence interval: 0.01-0.30) per day (P = 0.047). Ninety percent of patients were discharged with at least 1 issue. The 3 most common barriers on the admission and discharge survey remained the same: pain, lack of understanding of recovery plan, and daily-living activities. CONCLUSIONS: Patient-reported barriers to discharge are prevalent and incompletely addressed. This suggests an opportunity for improved discharge planning and a framework for communication between providers and patients. Journal of Hospital Medicine 2016;11:610-614.
No takes yet. Share an insight, caveat, or question.
Harrison et al. (2016) conducted an observational in Hospital admission (n=163). Hospitalization was evaluated on Prevalence of discharge barriers, rates of resolution of barriers during hospitalization, and comparisons between barriers identified in admission and discharge surveys (decrease of 0.15 barriers per day, 95% CI 0.01-0.30, p=0.047). The total number of patient-reported barriers to discharge decreased by an average of 0.15 per day (95% CI 0.01-0.30; P=0.047), yet 90% of patients were discharged with at least one barrier.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: