Nurse and Patient Perceptions of Discharge Readiness in Relation to Postdischarge Utilization

When a patient is readmitted to the hospital or uses an emergency department (ED) within 30 days following a hospital stay, it often is because they were not ready to leave the hospital. But nurses (who have primary responsibility for discharge) and patients have different perceptions of patient discharge readiness. To assess this difference, researchers independently asked patients and nurses in 16 medical-surgical units in four Midwestern hospitals about readiness for hospital discharge.

On a scale of one to 10, they were asked to rate:

  • How the patient is feeling on the day of the discharge.
  • How much the patient knows about self-management at home.
  • How well the patient will be able to manage care demands at home.
  • How much help and emotional support the patient will have.

Nurses reported greater levels of patient readiness than did patients themselves. Nurse assessment of discharge readiness was more strongly associated with post discharge ED use and rehospitalization than patient self-assessments.

By employing a formal discharge assessment tool to identify high-risk patients, nurses could help prevent repeat hospitalizations and ED use. Other interventions before discharge, including more patient teaching, could improve patient outcomes and satisfaction—and reduce costly adverse outcomes.