Transition from hospital to nursing home: Discharge planners as a potential lever for quality improvements?

Background: Public reporting is supposed to be helpful in differentiating between well and poorly performing nursing homes; however, hospital patients often have difficulties to deal with quality information. Discharge planners (DP) can support them in comparing quality and, by influencing patients' decision, lead to better provision of care in nursing homes.

Objective: This study investigated the choice behavior of DP, their use of quality information and the potential to impact the decision-making of patients.

Material and methods: A total of 70 DP from German hospitals with a geriatric department participated in an online survey. They were asked about information preferences and tools used for nursing home searches. In addition, they assessed quality information items from the new German quality reporting on a Likert scale. To test their comprehension participants were given a case scenario of a typical patient, were shown nursing homes displayed based on a medical comparison portal navigator (AOK-Pflegenavigator) and were asked to select nursing homes in a 3-round experiment.

Results: When looking for a nursing home, DP primarily rely on internal nursing home directories (n = 62; 92.5%). The 3 preferred criteria for decision are: distance to the family (n = 55; 28.80%), bed availability (n = 51; 26.7%) and wishes of patients/relatives (n = 41; 21.47%). The consent score for public reporting was 46.28% and the comprehension ratio was 82.24%.

Discussion: The DP do not advise hospital patients on the performance of nursing homes and rely on the decision-making of patients. This results in a lack of impact on patients' decisions and consequently in a loss of potential for public reporting to lead to better care in nursing homes.