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Improving patient discharge and reducing hospital readmissions by using Intervention Mapping

Improving patient discharge and reducing hospital readmissions by using Intervention Mapping
Improving patient discharge and reducing hospital readmissions by using Intervention Mapping
Background: There is a growing impetus to reorganize the hospital discharge process to reduce avoidable readmissions and costs. The aim of this study was to provide insight into hospital discharge problems and underlying causes, and to give an overview of solutions that guide providers and policy-makers in improving hospital discharge.

Methods: The Intervention Mapping framework was used. First, a problem analysis studying the scale, causes, and consequences of ineffective hospital discharge was carried out. The analysis was based on primary data from 26 focus group interviews and 321 individual interviews with patients and relatives, and involved hospital and community care providers. Second, improvements in terms of intervention outcomes, performance objectives and change objectives were specified. Third, 220 experts were consulted and a systematic review of effective discharge interventions was carried out to select theory-based methods and practical strategies required to achieve change and better performance.

Results: Ineffective discharge is related to factors at the level of the individual care provider, the patient, the relationship between providers, and the organisational and technical support for care providers. Providers can reduce hospital readmission rates and adverse events by focusing on high-quality discharge information, well coordinated care, and direct and timely communication with their counterpart colleagues. Patients, or their carers, should participate in the discharge process and be well aware of their health status and treatment. Assessment by hospital care providers whether discharge information is accurate and understood by patients and their community counterparts, are important examples of overcoming identified barriers to effective discharge. Discharge templates, medication reconciliation, a liaison nurse or pharmacist, regular site visits and teach-back are identified as effective and promising strategies to achieve the desired behavioural and environmental change.

Conclusions: This study provides a comprehensive guiding framework for providers and policy makers to improve patient handover from hospital to primary care.
patient handoff, patient discharge, patient readmission, intervention mapping, adverse events
1472-6963
1-11
Hesselink, G.
4156a7fb-a6b3-4ba8-bddd-7394c22b0f32
Zegers, M.
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Vernooij-Dassen, M.
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Barach, P.
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Kalkman, C.
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Flink, M.
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Öhlén, G.
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Olssen, M.
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Bergenbrant, S.
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Orrego, C.
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Suñol, R.
67955b52-783f-452b-894c-87ba42b23647
Toccafondi, G.
437fc7c3-f754-4c20-b55f-59c6f1ee456e
Venneri, F.
612ee088-162c-4e27-8dea-b0dc7d0ad99a
Dudzik-Urbaniak, E.
01d9b37f-414c-4318-97c5-39f8cb4e8eed
Kutryba, B.
ddb36dfc-af15-4b04-8d77-85bf4f840833
Schoonhoven, Lisette
46a2705b-c657-409b-b9da-329d5b1b02de
Wollersheim, H.
5e67270e-394d-41b8-b2c3-d0c7d14f00e7
Hesselink, G.
4156a7fb-a6b3-4ba8-bddd-7394c22b0f32
Zegers, M.
36ab3198-e5bb-4310-800b-529352c7effe
Vernooij-Dassen, M.
c1923cc4-6d57-4d0a-8810-e90ba35279e1
Barach, P.
69ad6a57-8f9c-4a35-af61-f147784a09a1
Kalkman, C.
d2b2ba91-eb39-4fbc-95d5-f7b6b37b139d
Flink, M.
53a3fd2a-6dde-497d-9a2a-b287dc2375fe
Öhlén, G.
454eff4a-6b7b-4113-972c-6c7eb97f886f
Olssen, M.
259faa88-b78d-433d-872c-d7f211b41526
Bergenbrant, S.
3ef7fe43-e35c-4c0e-be4b-30495d7aee2a
Orrego, C.
a314325b-7259-44f3-b58e-4ed33b0e06c0
Suñol, R.
67955b52-783f-452b-894c-87ba42b23647
Toccafondi, G.
437fc7c3-f754-4c20-b55f-59c6f1ee456e
Venneri, F.
612ee088-162c-4e27-8dea-b0dc7d0ad99a
Dudzik-Urbaniak, E.
01d9b37f-414c-4318-97c5-39f8cb4e8eed
Kutryba, B.
ddb36dfc-af15-4b04-8d77-85bf4f840833
Schoonhoven, Lisette
46a2705b-c657-409b-b9da-329d5b1b02de
Wollersheim, H.
5e67270e-394d-41b8-b2c3-d0c7d14f00e7

Hesselink, G., Zegers, M., Vernooij-Dassen, M., Barach, P., Kalkman, C., Flink, M., Öhlén, G., Olssen, M., Bergenbrant, S., Orrego, C., Suñol, R., Toccafondi, G., Venneri, F., Dudzik-Urbaniak, E., Kutryba, B., Schoonhoven, Lisette and Wollersheim, H. (2014) Improving patient discharge and reducing hospital readmissions by using Intervention Mapping. BMC Health Services Research, 14 (389), 1-11. (doi:10.1186/1472-6963-14-389). (PMID:25218406)

Record type: Article

Abstract

Background: There is a growing impetus to reorganize the hospital discharge process to reduce avoidable readmissions and costs. The aim of this study was to provide insight into hospital discharge problems and underlying causes, and to give an overview of solutions that guide providers and policy-makers in improving hospital discharge.

Methods: The Intervention Mapping framework was used. First, a problem analysis studying the scale, causes, and consequences of ineffective hospital discharge was carried out. The analysis was based on primary data from 26 focus group interviews and 321 individual interviews with patients and relatives, and involved hospital and community care providers. Second, improvements in terms of intervention outcomes, performance objectives and change objectives were specified. Third, 220 experts were consulted and a systematic review of effective discharge interventions was carried out to select theory-based methods and practical strategies required to achieve change and better performance.

Results: Ineffective discharge is related to factors at the level of the individual care provider, the patient, the relationship between providers, and the organisational and technical support for care providers. Providers can reduce hospital readmission rates and adverse events by focusing on high-quality discharge information, well coordinated care, and direct and timely communication with their counterpart colleagues. Patients, or their carers, should participate in the discharge process and be well aware of their health status and treatment. Assessment by hospital care providers whether discharge information is accurate and understood by patients and their community counterparts, are important examples of overcoming identified barriers to effective discharge. Discharge templates, medication reconciliation, a liaison nurse or pharmacist, regular site visits and teach-back are identified as effective and promising strategies to achieve the desired behavioural and environmental change.

Conclusions: This study provides a comprehensive guiding framework for providers and policy makers to improve patient handover from hospital to primary care.

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More information

Accepted/In Press date: 10 September 2014
Published date: 13 September 2014
Keywords: patient handoff, patient discharge, patient readmission, intervention mapping, adverse events
Organisations: Faculty of Health Sciences

Identifiers

Local EPrints ID: 380926
URI: http://eprints.soton.ac.uk/id/eprint/380926
ISSN: 1472-6963
PURE UUID: 8f04ba81-9ccb-49ca-8206-e80d6b48b0bd
ORCID for Lisette Schoonhoven: ORCID iD orcid.org/0000-0002-7129-3766

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Date deposited: 21 Sep 2015 12:42
Last modified: 15 Mar 2024 03:41

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Contributors

Author: G. Hesselink
Author: M. Zegers
Author: M. Vernooij-Dassen
Author: P. Barach
Author: C. Kalkman
Author: M. Flink
Author: G. Öhlén
Author: M. Olssen
Author: S. Bergenbrant
Author: C. Orrego
Author: R. Suñol
Author: G. Toccafondi
Author: F. Venneri
Author: E. Dudzik-Urbaniak
Author: B. Kutryba
Author: H. Wollersheim

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