A last thing to consider when trying to make changes to improve discharge practices is to make certain that you put into place measures to inform the work you are doing. Strong discharge improvement plan needs outcome, process, and balancing measures. Some suggestions are below, but develop those that are meaningful to your patients as well.
Outcome measures
- 7-day and 30-day readmissions
- 7-day and 30-day ED revisits
- post-discharge adverse drug events
- patient-reported understanding of discharge plan
Process measures
- percentage of patients with discharge medication reconciliation completed
- percentage with follow-up appointment scheduled before discharge
- percentage receiving teach-back documentation
- percentage of discharge summaries sent to next clinician within 24 hours
- percentage of high-risk patients receiving post-discharge call within 72 hours
- percentage of pending tests with documented owner
Balancing measures
- discharge delays caused by process burden
- clinician workload
- callback volume
- patient complaints about conflicting instructions