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An emergency department-based nurse discharge coordinator for elder patients: does it make a difference?
Alex Guttman1, Marc Afilalo, Rivka Guttman
1Emergency Department, Sir Mortimer B. Davis-Jewish General Hospital, McGill University, Montreal, Quebec, Canada. alex.guttman@mcgill.ca
Summary
A nurse discharge plan coordinator (NDPC) in the emergency department (ED) reduced unscheduled patient return visits. This intervention improved elder patients' satisfaction and well-being after discharge.
Area of Science:
- Geriatric Medicine
- Emergency Medicine
- Healthcare Management
Background:
- Elderly patients discharged from the emergency department (ED) often face challenges transitioning back home.
- These challenges can lead to increased unscheduled return visits, decreased patient satisfaction, and reduced well-being.
Purpose of the Study:
- To evaluate the impact of an ED-based nurse discharge plan coordinator (NDPC) on elderly patients.
- Key outcomes included unscheduled return visits within 14 days, satisfaction with discharge, adherence to instructions, and perceived well-being.
Main Methods:
- A pre/post study design was employed with patients aged 75 and older discharged from the ED.
- The control phase (n=905) received standard care, while the intervention phase (n=819) included an NDPC providing education, appointment coordination, and follow-up.
Main Results:
- The intervention group, though sicker at baseline, showed a reduced relative risk for unscheduled return visits (0.79).
- A 27% risk reduction was observed up to 8 days post-discharge, and 19% up to 14 days.
- Significant increases in satisfaction with discharge information clarity and perceived well-being were noted.
Conclusions:
- An ED-based NDPC specifically for elder patients effectively reduces unscheduled ED return visits.
- The intervention facilitates a smoother transition from the ED to home and community healthcare networks.