Social resource assessment: Application of a novel communication tool during hospital discharge

To evaluate an interactive tool designed to help patients communicate their social resources supportive of home recovery to health care providers.

Seventy medical and surgical inpatients completed the D-CEGRM social resource interview, demographic queries, and discharge readiness surveys (RHDS) at discharge. Two weeks later, patients completed post-discharge coping difficulty surveys (PDCDS). Nurses unassociated with patients' clinical care reviewed structured clinical notes created from the D-CEGRM and categorized patients as likely to have "inadequate" or "adequate" supportive resources for home self-management. Nurse decision making was tracked using an adjudication process, and post-hoc comparisons in patient characteristics, RHDS, and PDCDS were conducted.

Nurses categorized 36 patients (51%) as having inadequate resources. Number and accessibility of supports, presence of negative relationships, and previous struggles meeting health-related needs were important decision-making factors. Post-hoc comparisons revealed significant differences in demographic risk factors and discharge readiness ratings for those with inadequate vs. adequate resources.

The D-CEGRM may be an efficient tool for patients to communicate access to social resources, and an effective facilitator of transitional care planning.

The D-CEGRM may provide a useful assessment of patients' home context and guide for transitional care planning.