Developing Best Practice Guidance for Discharge Planning Using the RAND/UCLA Appropriateness Method.

Area of Science:

• Mental Health Research
• Healthcare Management
• Patient Safety

Background:

• Discharge from acute mental health inpatient units presents significant patient vulnerability.
• Lack of standardized processes and inter-agency communication failures complicate patient transitions.
• Improved discharge planning and procedural standardization are crucial for enhancing inpatient care safety.

Purpose of the Study:

• To develop best practice guidance for mental health discharge planning.
• To support safer patient transitions from inpatient to community settings.
• To adapt the 6-component SAFER patient flow bundle for mental health settings.

Main Methods:

• Utilized the RAND/UCLA Appropriateness method with a 10-member expert stakeholder panel.
• Rated 668 evidence-based statements on clarity, appropriateness, and feasibility using online surveys and meetings.
• Focused on 10 potential components of discharge planning best practice.

Main Results:

• Five of the six SAFER patient flow bundle components were deemed appropriate and feasible.
• "Early Flow" was identified as inappropriate due to the need for flexibility in mental health settings.
• 285 statements were rated appropriate and feasible; 44 were appropriate but not feasible.

Conclusions:

• Identified key components for a best practice discharge planning guidance in UK mental health settings.
• Standardizing existing clinical processes, like senior clinician review, can yield significant safety benefits.
• A tailored and timely approach to post-discharge care is essential for patient well-being.