Communicating Patient Discharge Readiness: An Implementation Evaluation in an Inpatient Hospital Medicine Setting

J Nurs Care Qual. 2023 Sep 8. doi: 10.1097/NCQ.0000000000000738. Online ahead of print.

Abstract

Background: The progression of patients through a hospital from admission to discharge can be slowed by delays in patient discharge, increasing pressure on health care staff. We designed and piloted the Discharge Today tool, with the goal of improving the efficiency of patient discharge; however, adoption remained low.

Purpose: To close this implementation gap, we deployed and evaluated a 4-part implementation strategy bundle.

Methods: We measured the success of implementation by evaluating validated implementation outcomes using both quantitative and qualitative methods, grounded in Normalization Process Theory.

Results: The implementation strategies used were effective for increasing use of the Discharge Today tool by hospital medicine physicians and advanced practice providers during both the active and passive implementation periods.

Conclusions: While the implementation strategies used were effective, qualitative findings indicate that limitations in the functionality of the tool, alongside inconsistent use of the tool across clinical staff, continued to inhibit adoption.