Socwell C.1, Kanagasaba K.1, Pope R.1
1Bond University, Doctor of Physiotherapy Program, Robina, Australia
Background: Early identification of patients with complex discharge planning needs is crucial in the hospital setting to optimise care, decrease patient length of stay, and increase patient satisfaction. The Early Screen for Discharge Planning (ESDP) is the first known tool for early identification of patients requiring referral to specialised discharge planning services.
Purpose: The aim of this systematic review with critical narrative synthesis was to identify and synthesise available research evidence on the utility of the Mayo Clinic's ESDP as a tool for identifying patients early during their hospital stay who will require referral to specialised hospital discharge planning services (SHDCPS) in order to ensure optimal outcomes.
Methods: A systematic search was conducted of PubMed, CINAHL, Embase, and ProQuest databases using the following search string: ((Mayo Clinic AND Discharge planning) OR ESDP OR Early Screen for Discharge Planning). Titles and abstracts were screened to remove duplicates and clearly ineligible articles. Full text of remaining articles was assessed for eligibility and the studies in the final included set were critically appraised before data extraction, tabulation, and critical narrative synthesis of key findings.
Results: Five studies (N = 1,291 patients) examining the utility of the ESDP tool were eligible for inclusion. All five studies reported the use of SHDCPS as an outcome measure. One study (N = 303) found the ESDP tool was a significant predictor of patient referral to and use of SHDCPS (AUC = 0.822). Another study
(N = 122) found that the addition of the Health Self-Determinism Index (HSDI) added no additional predictive value to the ESDP, but on its own, the ESDP was a valid predictor of the use of SHDCPS
(Χ2 = 10.85, df = 1, p = 0.001). One study (N = 371) found that upon implementation of the tool in the hospital, mean patient length of stay decreased from 8.0 to 6.4 days (~20%). A further study (N = 195) found that patients with a high ESDP score reported significantly more discharge problems [mean, (standard deviation), 16.3 (8.7), p 0.01] in the first few weeks after discharge than low-scoring patients [12.2 (8.4), p = 0.02]. The fifth study (N = 300) tested the ESDP in colorectal surgery patients and found that professional screening of patients after receiving a negative ESDP score ( 10) was the best practice for identifying post-acute care (PAC) needs in high 30-day readmission risk patients.
Conclusion(s): All studies were of good or high quality and together provided evidence that the ESDP tool is a valid and efficient way for hospital staff to identify early those patients needing referral to SHDCPS. Further studies are required to review the predictive ability of the ESDP tool in measuring variables such as length of hospital stay, readmission rate, and discharge destination.
Implications: The ESDP should be considered by hospitals for implementation as a valid and efficient means of identifying patients with more complex discharge planning needs and so improving their outcomes.
Funding acknowledgements: No authors were compensated for the development of this manuscript.
Topic: Professional practice: other
Ethics approval: Ethics approval was not required for this manuscript.
All authors, affiliations and abstracts have been published as submitted.
