Development and validation of a screen for specialized discharge planning services

Area of Science:

• Healthcare Management
• Clinical Informatics
• Patient Care Services

Background:

• Lack of validated screening tools for early identification of patients requiring specialized hospital discharge planning services.
• Need for a reliable method to predict service utilization at the beginning of a hospital stay.

Purpose of the Study:

• To develop and validate a screening tool using hospital admission clinical data.
• To discriminate between adult patients who will and will not utilize specialized discharge planning services.

Main Methods:

• Prospective sampling of adult patients across two hospitals (development and validation samples).
• Identification of predictive variables from literature, interviews, record reviews, and administrative databases.
• Outcome defined as documented referral for specialized discharge planning services.

Main Results:

• Age, disability, living alone, and self-rated walking limitation were jointly predictive of service use.
• A screening score was developed with a sensitivity of 75% and specificity of 78% in the development sample.
• The screening tool demonstrated equal performance in the validation sample.

Conclusions:

• A validated screening tool with few, readily available characteristics was developed.
• The tool accurately predicts the need for specialized discharge planning services early in hospitalization.
• Implementation can assist providers in appropriate and timely service deployment.