Scoping Review of Adult Emergency Department Discharge Interventions

Area of Science:

• Emergency Medicine
• Health Services Research
• Patient Safety

Background:

• The emergency department (ED) discharge process significantly impacts patient outcomes.
• Poor discharge quality is a common issue, yet comprehensive reviews of interventions are lacking.

Purpose of the Study:

• To conduct a scoping, summative review of adult ED discharge interventions.
• To identify best practices and future research directions for improving ED discharge.

Main Methods:

• A systematic literature search was performed across major databases (MEDLINE, Embase, Cochrane, CINAHL) up to February 2023.
• Included 100 studies published between 2003-2023, focusing on ED-based discharge interventions for adults.
• Excluded studies on pediatric populations, non-ED settings, and interventions primarily post-discharge.

Main Results:

• Interventions focused on enhancing patient comprehension of discharge instructions showed the greatest impact.
• Effective strategies included dedicated personnel for discharge discussions, structured checklists, and appropriate reading levels for instructions.
• Limited research exists on long-term patient outcomes, cost-benefit analyses, and the experiences of vulnerable populations.

Conclusions:

• Interventions improving patient understanding of discharge information are most effective.
• The review identifies promising avenues for patient-centered ED discharge innovation.
• Further research is crucial to optimize the adult ED discharge process, especially for underserved groups.