Fast track patients’ satisfaction, compliance and confidence with emergency department discharge planning

Mrs Leahanna Stevens1, Ms Margaret Fry2, Mr Michael Browne3, Mr  Arthit Barnes1

1Mersey Community Hospital, Latrobe, Asutralia , 2University of Technology Sydney, Sydney, Australia , 3Royal Hobart Hospital , Hobart, Australia

Abstract:

Background:
Across Australia over one million patients are discharged from the emergency department (ED) back to their place of residence. Discharge planning involves the communication of healthcare information to optimise patient safety, self-management, and understanding and compliance with ongoing treatment. Inappropriate discharge planning or patient healthcare information understanding could result in worsening of a patient’s presenting condition, illness and/or injury, or lead to avoidable deterioration. Little is known about the adequacy of discharge planning or delivery of health care information to patients in the ED. Therefore, the aim of this study was to explore the experience, confidence, satisfaction and perceptions of patients recently discharged from ED.

Methods:
The descriptive exploratory study was conducted in one district Tasmanian hospital. Data collection involved patient telephone interviews and a retrospective medical record audit.

Results:
A convenience sample of 100 patients was used for the study. Overall, the majority (93%) of patients understood their ED treatment, were confident to be discharged home (88%), and satisfied (90%) with ED care. The majority of patients’ understood their discharge diagnosis (86%) and were  provided with verbal (84%) discharge information. Discharge referral instructions were followed up by 60% of patients with 26% of patients re-presenting to ED.

Conclusions:
The study highlighted that the majority of patients were satisfied with ED care, complied with discharge healthcare information and confident to be discharged. However, a number of patients failed to adhere to discharge follow up advice and re-presented to the ED.

Key words:
Emergency Medicine; discharge instructions; compliance; satisfaction; patient communication; discharge planning


Biography:

Leahanna Stevens, originally from the Gold Coast QLD has over 20 years of experience in Emergency Nursing. She was one of the first Nurse Practitioners to go through the QUT program in 2007 for the Masters of Nursing Science, NP and pioneered the position in the Gold Coast Hospital ED. She has remained an Emergency NP for the past 12 years.

Three years ago, she left the busy trauma ED on the Gold Coast for a more relaxed easy-going lifestyle for herself and her young family in Tasmania. She loves to run and explore the island wineries in her free time whilst spending quality time with her family.

Leahanna now works in the smaller regional ED of the Mersey Community Hospital with two other fellow NPs. Together they coordinate and run the often very busy Fast Track area. Their focus is on the ambulatory care however they also flex into the acute and resuscitation zones when their expertise is needed.

Leahanna has a keen interest in the communication and discharge process. She believes that by empowering her patients with the education and knowledge of their healthcare conditions can only be beneficial in potentially improving compliance, wellbeing and reducing ED representation and utilising GP services.