Construction and clinical validation of a Team STEPPS-based discharge planning program for patients with inflammatory...

The transition from hospital to home is a high-risk period for patients with Inflammatory Bowel Disease (IBD). This study aimed to develop and preliminarily validate a structured discharge planning program for patients with IBD by applying the Team STEPPS framework.

This study employed a sequential two-phase, mixed-methods design. First, a Team STEPPS-based discharge planning program was rigorously developed using Delphi method between August and October 2023. Subsequently, a randomized controlled trial was conducted from October 2023 to March 2024 to validate the program. Ninety eligible inpatients were randomly assigned to an intervention group (n = 45) receiving the structured Team STEPPS program or a control group (n = 45) receiving standard care. The primary outcome was discharge readiness, assessed at the time of discharge. Secondary outcomes included the quality of discharge teaching, measured at discharge, and health-related quality of life, evaluated at baseline, discharge, and 30-day follow-up. Longitudinal outcomes analyzed via linear mixed-effects models.

All 90 enrolled participants completed the study. The Delphi process successfully achieved expert consensus, resulting in a structured discharge program with all items meeting predefined criteria (mean importance ≥ 4.0, coefficient of variation ≤ 0.25). In the subsequent randomized controlled trial, baseline characteristics were well-balanced. At discharge, the intervention group exhibited statistically superior outcomes, including significantly higher discharge readiness (103.0 ± 7.3 vs. 94.9 ± 4.7, P < 0.001) and quality of discharge teaching scores (183.6 ± 6.4 vs. 172.7 ± 5.0, P < 0.001). Longitudinal analysis of health-related quality of life revealed a significant group-by-time interaction effect (P < 0.001), with the intervention group demonstrating a greater magnitude of improvement. The model estimated an incremental benefit of the intervention of 9.2 points (95% CI: 5.7-12.7) at the 30-day follow-up compared to standard care.

A Team STEPPS-based discharge planning program was successfully developed and shown to be effective, significantly improving discharge readiness, the quality of discharge teaching, and health-related quality of life in patients with IBD.

https://www.chictr.org.cn/index.html, identifier ChiCTR2501113716.