Implementation of the Discharge Planning Checklist for Surgical Patients in an Evidence-Based Approach
By Kency KC Chan, RN, BN, MN, FHKAN
The aims of this evidence-based practice project were to (1) facilitate an improved process for early discharge planning to inform and integrate care, (2) improve patient experience and outcomes, and (3) engage patients and their caregivers in the patient care planning process. Patient and caregiver engagement was targeted via enhanced nurses’ clinical practice and improved communication during clinical handover.
The perception and understanding of hospital discharge by health professionals is important in developing effective discharge planning. Timeliness of the discharge planning process is essential and should be organized with patient/family engagement prioritized as a part of integrated care. The efficient patient flow across care transitions with appropriate use of resources and optimizes both reimbursement and clinical quality. Nurses have a professional responsibility to ensure that healthcare records provide an accurate account of treatment, care planning and delivery to communicate within the team.
Baseline surveys and interviews were collected from 37 nurse respondents of an adult surgical ward regarding the satisfaction with and attitudes about documentation for surgical patients on the current discharge planning form. An evidence-based discharge planning checklist was designed and implemented for surgical patients during August to October in 2016. Pre-and Post-implementation data were analyzed for the effectiveness of the surgical discharge
There were 871 surgical discharge planning checklists were used in general, special surgeries and endoscopic procedures during the project period. The nurses’ respondents rating of their discharge planning skills and concerns were improved by 31% and 26% respectively. Perception of checklist utility improved by 33%. Surgical staff satisfaction with clinical handover improved by 28% after implementation of the surgical discharge planning checklist.
Overall, nurses reported that health education is a critical element of discharge education. The discharge checklist is a potential solution with immediate impact that may improve discharge communication. The discharge planning assessment is an important factor affecting the quality
of patients’ discharge plans.
Acceptance and compliance are crucial for checklist implementation in healthcare. Feedback from nurses may provide valuable input for successful checklist implementation in this setting. The findings from this project suggest that nurse respondents value the checklist as a tool to improve communication and clinical handover. Further investigation is warranted to determine if adopting our recommendations leads to improved communication, teamwork, or patient satisfaction.