OBJECTIVES: To evaluate the impact of an emergency department (ED)-based nurse discharge plan coordinator (NDPC) on unscheduled return visits within 14 days of discharge, satisfaction with discharge recommendations, adherence with discharge instructions, and perception of well-being of elder patients discharged from the ED. METHODS: Patients aged 75 years and older discharged from the ED of the Sir Mortimer B. Davis-Jewish General Hospital were recruited in a pre/post study. During the pre (control) phase, study patients (n = 905) received standard discharge care. Patients in the post (intervention) phase (n = 819) received the intervention of an ED-based NDPC. The intervention included patient education, coordination of appointments, patient education, telephone follow-up, and access to the NDPC for up to seven days following discharge. RESULTS: Patients in the two groups were similar with respect to gender and age. However, the patients managed by the ED NDPC appeared to be, at baseline, less autonomous, frailer, and sicker. The unadjusted relative risk for unscheduled return visits within 14 days of discharge was 0.79 (95% confidence interval [95% CI] = 0.62 to 1.02). A relative risk reduction of 27% (95% CI = 0% to 44%) for unscheduled return visits was observed for up to eight days postdischarge, and a relative risk reduction of 19% (95% CI = -2% to 36%) for unscheduled return visits was observed for up to 14 days postdischarge. Significant increases in satisfaction with the clarity of discharge information and perceived well-being were also noted. CONCLUSIONS: An ED-based NDPC, dedicated specifically to the discharge planning care of elder patients, reduces the proportion of unscheduled ED return visits and facilitates the transition from ED back home and into the community health care network.
OBJECTIVES: To evaluate the impact of an emergency department (ED)-based nurse discharge plan coordinator (NDPC) on unscheduled return visits within 14 days of discharge, satisfaction with discharge recommendations, adherence with discharge instructions, and perception of well-being of elder patients discharged from the ED. METHODS:Patients aged 75 years and older discharged from the ED of the Sir Mortimer B. Davis-Jewish General Hospital were recruited in a pre/post study. During the pre (control) phase, study patients (n = 905) received standard discharge care. Patients in the post (intervention) phase (n = 819) received the intervention of an ED-based NDPC. The intervention included patient education, coordination of appointments, patient education, telephone follow-up, and access to the NDPC for up to seven days following discharge. RESULTS:Patients in the two groups were similar with respect to gender and age. However, the patients managed by the ED NDPC appeared to be, at baseline, less autonomous, frailer, and sicker. The unadjusted relative risk for unscheduled return visits within 14 days of discharge was 0.79 (95% confidence interval [95% CI] = 0.62 to 1.02). A relative risk reduction of 27% (95% CI = 0% to 44%) for unscheduled return visits was observed for up to eight days postdischarge, and a relative risk reduction of 19% (95% CI = -2% to 36%) for unscheduled return visits was observed for up to 14 days postdischarge. Significant increases in satisfaction with the clarity of discharge information and perceived well-being were also noted. CONCLUSIONS: An ED-based NDPC, dedicated specifically to the discharge planning care of elder patients, reduces the proportion of unscheduled ED return visits and facilitates the transition from ED back home and into the community health care network.
Authors: Christopher R Carpenter; Elizabeth R Bassett; Grant M Fischer; Jonathan Shirshekan; James E Galvin; John C Morris Journal: Acad Emerg Med Date: 2011-04 Impact factor: 3.451
Authors: Susan N Hastings; Karen M Stechuchak; Cynthia J Coffman; Elizabeth P Mahanna; Morris Weinberger; Courtney H Van Houtven; Kenneth E Schmader; Cristina C Hendrix; Chad Kessler; Jaime M Hughes; Katherine Ramos; G Darryl Wieland; Madeline Weiner; Katina Robinson; Eugene Oddone Journal: J Gen Intern Med Date: 2019-09-05 Impact factor: 5.128
Authors: Manish N Shah; Matthew M Hollander; Courtney Mc Jones; Thomas V Caprio; Yeates Conwell; Jeremy T Cushman; Eva H DuGoff; Amy J H Kind; Michael Lohmeier; Ranran Mi; Eric A Coleman Journal: J Am Geriatr Soc Date: 2018-08-10 Impact factor: 5.562
Authors: Hunter Singh Lau; Matthew M Hollander; Jeremy T Cushman; Eva H DuGoff; Courtney M C Jones; Amy J H Kind; Michael T Lohmeier; Eric A Coleman; Manish N Shah Journal: Prehosp Emerg Care Date: 2018-02-12 Impact factor: 3.077
Authors: Carolyn Horney; Kenneth Schmader; Linda L Sanders; Mitchell Heflin; Luna Ragsdale; Eleanor McConnell; Michael Hocker; S Nicole Hastings Journal: Am J Emerg Med Date: 2011-01-08 Impact factor: 2.469
Authors: Ula Hwang; Manish N Shah; Jin H Han; Christopher R Carpenter; Albert L Siu; James G Adams Journal: Health Aff (Millwood) Date: 2013-12 Impact factor: 6.301