Andrea S Wallace, Sonja E Raaum, Erin Phinney Johnson, Angela P Presson, Chelsea M Allen, Mackenzie Elliott, Alycia A Bristol, Catherine E Elmore
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One result was decreased time of caregivers at the bedside of hospitalized patients.</p><p><strong>Objective: </strong>To understand the impact of pandemic-related system effects on patient-reported discharge preparation.</p><p><strong>Design: </strong>This mixed methods study included interviews with a sample of discharged patients during April 2020, and quantitative hospital data from April 2020 to February 2021.</p><p><strong>Participants: </strong>616 patients completed a measure of discharge readiness on their day of discharge and 38 patients completed interviews about their discharge experiences.</p><p><strong>Main measures: </strong>Readiness for discharge (RHDS), visitation policies, ward structure changes, COVID-19-unit census, time into the COVID-19 pandemic, patient characteristics (age, sex, race/ethnicity), admission type (planned/unplanned, for COVID-19), and discharge destination (home, home health, skilled nursing).</p><p><strong>Key results: </strong>Adult patients aged 30-45 (vs. young and older adult patients) and those being discharged to places other than home (e.g., skilled nursing facility) or to out-of-state residences report lower readiness (<i>p</i> < 0.05) on RHDS. Patient interviews revealed some gaps in discharge communication but, overall, patients expressed high discharge readiness and few concerns about how COVID-19 system changes impacted their discharge preparation.</p><p><strong>Conclusions: </strong>While there is some evidence that visitation policies and unit census may impact patient perceptions of discharge preparation, personal characteristics contributed more significantly to discharge readiness than system changes during COVID-19. Participant interviews demonstrated agreement, as most participants were discharged home and identified strong personal feelings of readiness for discharge.<i>Clinical trials registration</i>: ClinicalTrials.gov ID NCT04248738, https://clinicaltrials.gov/ct2/show/NCT04248738.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s44250-023-00060-8.</p>","PeriodicalId":72826,"journal":{"name":"Discover health systems","volume":"2 1","pages":"45"},"PeriodicalIF":0.0000,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10689550/pdf/","citationCount":"0","resultStr":"{\"title\":\"Impact of COVID-19 visitation policies and hospital capacity on discharge readiness in medicine patients.\",\"authors\":\"Andrea S Wallace, Sonja E Raaum, Erin Phinney Johnson, Angela P Presson, Chelsea M Allen, Mackenzie Elliott, Alycia A Bristol, Catherine E Elmore\",\"doi\":\"10.1007/s44250-023-00060-8\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>COVID-19 impacted the experience of being hospitalized with the widespread adoption of strict visitation policies to ensure healthcare worker safety. 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引用次数: 0
摘要
背景:COVID-19影响了住院体验，广泛采用严格的探视政策以确保医护人员的安全。结果之一是减少了护理人员在住院患者床边的时间。目的:了解大流行相关系统效应对患者报告出院准备的影响。设计:这项混合方法研究包括对2020年4月出院患者样本的访谈，以及2020年4月至2021年2月的定量医院数据。参与者:616名患者在出院当天完成了出院准备措施，38名患者完成了关于出院经历的访谈。主要措施:出院准备情况(RHDS)、探视政策、病房结构变化、COVID-19单位普查、进入COVID-19大流行的时间、患者特征(年龄、性别、种族/民族)、入院类型(计划/计划外，针对COVID-19)、出院目的地(家庭、家庭健康、熟练护理)。关键结果:30-45岁的成年患者(相对于年轻和老年成年患者)和那些出院到家庭以外的地方(例如，熟练护理机构)或州外住所的患者报告的出院准备较低(p)结论:虽然有证据表明探视政策和单位普查可能会影响患者对出院准备的看法，但在COVID-19期间，个人特征对出院准备的贡献比系统变化更大。参与者访谈证明了这一点，因为大多数参与者出院回家，并确定了强烈的个人出院准备情绪。临床试验注册:ClinicalTrials.gov ID NCT04248738, https://clinicaltrials.gov/ct2/show/NCT04248738.Supplementary信息:在线版本包含补充材料，可在10.1007/s44250-023-00060-8获得。
Impact of COVID-19 visitation policies and hospital capacity on discharge readiness in medicine patients.
Background: COVID-19 impacted the experience of being hospitalized with the widespread adoption of strict visitation policies to ensure healthcare worker safety. One result was decreased time of caregivers at the bedside of hospitalized patients.
Objective: To understand the impact of pandemic-related system effects on patient-reported discharge preparation.
Design: This mixed methods study included interviews with a sample of discharged patients during April 2020, and quantitative hospital data from April 2020 to February 2021.
Participants: 616 patients completed a measure of discharge readiness on their day of discharge and 38 patients completed interviews about their discharge experiences.
Main measures: Readiness for discharge (RHDS), visitation policies, ward structure changes, COVID-19-unit census, time into the COVID-19 pandemic, patient characteristics (age, sex, race/ethnicity), admission type (planned/unplanned, for COVID-19), and discharge destination (home, home health, skilled nursing).
Key results: Adult patients aged 30-45 (vs. young and older adult patients) and those being discharged to places other than home (e.g., skilled nursing facility) or to out-of-state residences report lower readiness (p < 0.05) on RHDS. Patient interviews revealed some gaps in discharge communication but, overall, patients expressed high discharge readiness and few concerns about how COVID-19 system changes impacted their discharge preparation.
Conclusions: While there is some evidence that visitation policies and unit census may impact patient perceptions of discharge preparation, personal characteristics contributed more significantly to discharge readiness than system changes during COVID-19. Participant interviews demonstrated agreement, as most participants were discharged home and identified strong personal feelings of readiness for discharge.Clinical trials registration: ClinicalTrials.gov ID NCT04248738, https://clinicaltrials.gov/ct2/show/NCT04248738.
Supplementary information: The online version contains supplementary material available at 10.1007/s44250-023-00060-8.
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