The CARS Study: Communicating About Readiness (for Discharge)

The purpose of this study is to improve the experience of discharge of adult medical
surgical patients through improved discharge preparation communication between patients and
care team members, with subsequent improvement in the post-discharge experience. Obtaining
multiple perspectives on discharge readiness creates the opportunity for patient and care
team to partner in identifying deficiencies in discharge readiness that warrant
anticipatory, compensatory, or corrective interventions prior to discharge, with the goal of
averting post-discharge problems and utilization. The results will also inform development
and translation of tools for assessment of discharge readiness to clinical care
environments.

Specific Aims are to:

1. Describe patterns of communication about discharge and collaboration among members of
the health care team

2. Conduct psychometric testing of 3 forms of the Readiness for Hospital Discharge Scale
(RHDS - MD, RN, Patient)

3. Describe relationships between care team communication, patient perceptions of quality
of discharge preparation and perceived readiness for discharge, care team (RN and MD)
assessments of discharge readiness, and post-discharge outcome ( post-discharge coping
difficulty, Emergency Department (ED) use, and 30 day readmission.

4. Determine the impact of an intervention with the inpatient care team to improve
discharge preparation communication.

H1: Patient perceptions of discharge readiness, post-discharge coping difficulty, ED use and
readmission will improve following a care team educational intervention about discharge
preparation, compared to pre-intervention baseline measures.

H2: Care team members will report improved frequency and amount of discharge preparation
communication following a care team educational intervention about discharge preparation,
compared to pre-intervention baseline measures.

H3: RN-MD collaboration will increase following a care team educational intervention about
discharge preparation, compared to pre-intervention baseline measures