The Impact of a Nurse-Driven Discharge Planning Protocol on Patient Satisfaction and Quality Care

Introduction: Administration of evidence based discharge planning protocol and patient education ensures patient satisfaction, reduces readmission rates, improve quality care, and ensures safe adjustment of patients at home. However, effective delivery is a complex process which makes it challenging and time consuming. Many patients experience lack of discharge instruction accordingly to their specific disease processes and treatments, essential follow-up and identification of early warning signs for readmission. Therefore, individualized patient education and their transition from hospital to home, continuous guidance and support is essential to improve quality of care outcomes in the hospital.

Purpose: The purpose of the study is to determine the impact of a nurse-led discharge planning protocol in Heart, Lungs and Vascular (HLV) service line patients.

Methods: The development of the discharge planning protocol and implementation of a role of discharge nurse was introduced that endorsed individualized patient education based on medical diagnosis, and patients and families learning needs. The specialty based comprehensive discharge instructions and checklist were formulated for patients and caregivers. A telephonic helpline service model and data base of call records were also designed for post discharge patients to answer their queries, and to perform follow up calls after 24-48 hours to ensure their safe adjustment to home.

Results: The data was analyzed from January 2017 to September 2018, 7822 patients were discharged from HLV service line. The discharged nurse contacted all patients out of which 80% patients responded to the follow up calls and their concerns are managed at home. These concerns were also analyzed categorically and majority were dealt by discharge nurse only, very few were referred to consultants. This initiative led the overall patient satisfaction level to 90% in 2017 and 95% in 2018, and reduced readmission rates from 3 to 1 in 2018.

Conclusion: The nurse led discharge protocol endorses individualized patient educational needs, improved care outcomes, and her role acted as an evidence based change agent.