[Sensibility and specificity of a screening instrument for patients at risk of difficult discharge]

Planned discharge guarantees continuity of care. The process starts with the identification of patients at risk of post-discharge problems. In Italy no validated screening instruments are available. One of the UK discharge screening instruments is the Blaylock Risk Assessment Screening Score (BRASS), applicable from admission, for the identification of patients that need a discharge plan.

To assess the validity (sensitivity and specificity) of the BRASS scale on a sample of adult patients admitted to medical wards.

Patients admitted to medical wards of Trento Hospital from January to March 2006 were screened at admission and discharge and interviewed by phone 45 days after discharge to assess where they had been discharged.

One hundred eighty nine patients were assessed at admission and discharge and 145 were available at follow-up after 3 months; 7.5% were at risk for difficult discharge. Sensibility and specificity of the scale were respectively 73.1 and 83.2%. No major differences were observed for risk scores obtained at admission and discharge.

The BRASS scale collects a limited number of information, predictive on the need to organize discharge services. It can therefore be an useful instrument to help health care workers to plan appropriate and timely interventions for guaranteeing continuity of care.