Psychometric Evaluation of the Discharge Checklist

Validated discharge checklists can support discharge planning by enabling patients and care teams to systematically identify issues that hinder safe transitions from the hospital. This study evaluated the psychometric properties of a discharge checklist developed for use in a major tertiary care hospital.

Adult patients (>18 y) admitted to the general medicine service between February 2022 and August 2023 were eligible if discharge was anticipated within 24 to 48 hours at the time of approach. Participants completed the 15-item Discharge Checklist, PROMIS-29+2, and GLOBAL-10 questionnaires. Dimensionality was assessed using exploratory and confirmatory factor analyses. Internal consistency was evaluated using the Cronbach alpha and item-total correlations. Construct validity was examined through bivariate and multivariable analyses.

A total of 269 patients completed the discharge checklist: 212 (78.81%) were admitted following an emergency room visit, 87 (32.34%) had a hospital stay of 1 to 4 days, 86 (31.97%) had 4 to 5 comorbidities, and 162 (60.22%) were discharged home with self-care. The mean discharge checklist score was 11.42 (SD=3.42). Factor analyses supported a unidimensional model. Internal consistency was high (Cronbach alpha=0.85; item-total correlations 0.19-0.62). In multivariate analyses, younger age, shorter length of stay, and higher cognitive function and mental health were significantly associated with higher discharge checklist scores (ie, more prepared).

The questions in the discharge checklist combined to produce a scale with high internal consistency and construct validity. Future work should evaluate the implementation of these checklists more readily and as part of larger research or quality improvement programs for patients transitioning home.