College of Nursing
Inpatient readmissions are among the most severe problems facing hospitals. Readmissions are most common in the first two to five days after discharge, especially among veterans with mental illnesses at the Columbia Veteran Administration Hospital System (CVAHS) inpatient units. The discharge planning process should begin as soon as a patient is admitted and should be updated throughout the inpatient stay to ensure a safe transition of care from inpatient to outpatient. This Doctor of Nursing Practice (DNP) quality improvement project is aimed to develop and implement a standardized checklist to streamline and organize the discharge planning for all veterans admitted to the inpatient unit. The discharge checklist listed potential new patient discharge needs and was introduced at the first treatment team meeting. With its utilization, the checklist improved communication gaps within the inpatient treatment team and gave advanced knowledge of a patient's discharge needs early in the discharge process. The checklist also prepared the team and the patient for a successful transition from inpatient to outpatient care and enhanced patient transparency regarding their discharge plan. After a 90-day data collection period, veterans' post-discharge appointment attendance and readmission rates improved significantly by 88% compared to 90 days before the implementation. The discharge checklist was a cost-effective and efficient way to improve the discharge planning process, promote patient-provider communication, educate patients on the importance of attending post-discharge appointments, identify resources available, and ensure optimum conditions for successful outpatient treatment after discharge. Many treatment facilities and populations can benefit from a discharge checklist as an innovative and sustainable practice tool.
Milton-Williams, Henretta N., "Impact of a Standardized Checklist on Post Discharge Appointment Attendance and Readmission Rates of Veterans with a Mental Health Diagnosis" (2023). Doctor of Nursing Practice Scholarly Projects. 41.