Library Health Sciences

Facilitating the transition of elderly patients from the hospital setting to their pre-hospital environment is a major challenge for health care providers. Adequate discharge planning has been mandated by the Joint Commission on Accreditation of Health Care Organization (JCAHO) and the American Hospital Association (AHA). However, reports from the literature indicate that some elderly patients on Medicare may be discharged "quicker and sicker" than in the past and that care-giving family members are often not included in the discharge planning process.

The problem is that elderly patients may be discharged from the hospital before appropriate discharge planning is complete. The purpose of this pilot study was to determine elderly patients' and their family members' level of satisfaction and perceptions with the overall quality of hospital discharge planning.

The study addressed the following questions:. 1. What is the level of satisfaction reported by the elderly patient and the family member regarding discharge planning? 2. What are the perceptions of the elderly patient and family member with the overall quality of discharge planning? A descriptive, telephone survey design was used to determine elderly patients' and family members' satisfaction with hospital discharge planning. A telephone questionnaire was administered to a convenience sample of ten patients and ten family members between five to ten days after the patient was discharged from the hospital. The questionnaire consisted of closed-ended and open-ended questions. Demographic and closed-ended questions were analyzed using descriptive statistics, while open-ended questions were group and summarized. Satisfaction ratings were measured on a ten point scale, with ten indicating the highest satisfaction.

Findings of this pilot study indicated that elderly patients and their family members were satisfied with discharge planning and that nurses were often considered the most helpful in the discharge process. Average overall patient satisfaction was 9.6 and average family member satisfaction was 8.9. Areas receiving the highest satisfaction ratings included patients being involved in their discharge planning and instructions regarding medications, obtaining equipment and supplies, and wound care. Areas in need of improvement were identified as involving both patient and family member in the process, addressing activity level, inquiring about financial concerns and the possible need for additional help at home, and providing instructions about caring for the patient in the home environment.

Limitations of the pilot study as well as implications for nursing practice and education are described.

Recommendations for future research are discussed.

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