Quantitative

Data Collection and Reporting — Quantitative

Prior to implementing the BOOST discharge tool kit intervention, the team must assess the current state of the discharge process at the hospital. This requires obtaining and analyzing data at your hospital.

Baseline preintervention:Baseline preintervention: For the preceding year (monthly data as available).
You should develop data collection worksheets that you can use to collect baseline information on the following measures:

• Length of stay (LOS) — Monthly average among general medicine patients for the preceding 12 months, The ability to identify “outliers” (5% of patients with longest LOS) and separate from your analysis will be helpful. Alternatively, you can measure your median instead of mean LOS.
• Rehospitalization rate — Monthly average among general medicine patients for the preceding 12 months.
• Discharge Summary — Completion rate within 48 hours of discharge.
• Patient satisfaction — Monthly average among general medicine patients for the preceding 12 months.
  • Overall and specific to the discharge process — These will vary based on your survey vendor (eg, Press Ganey, Gallup). Listed below are examples of questions that your vendor may use to assess the discharge process.
  • You will want to track the proportion of patients reporting the highest level of satisfaction to example items such as these:
    • “Extent felt ready for discharge,”
    • “Speed of discharge process,”
    • “Instructions for care at home,”
    • “Explanations for taking medicines at home.”
• Results from H-CAHPS questions (required by CMS) available from your survey vendor. You need to track the proportion of patients reporting “yes” to the following questions contained in the HCAHPS survey.
  • During this hospital stay, did doctors, nurses, or other hospital staff talk with you about whether you would have the help you needed when you left the hospital? Yes or no.
  • During this hospital stay, did you get information in writing about what symptoms or health problems to look out for after you left the hospital? Yes or no.
• Patient or caregiver understanding — Utilizing a measurement tool (e.g. modified version of the Discharge Knowledge Assessment Tool), each hospital will survey a convenience sample of 50 patients (or their caregivers) prior to implementation of the intervention to determine their understanding of their:
  • Diagnosis — Primary cause of hospitalization.
  • Treatment in the hospital.
  • Follow-up appointment(s).
  • Warning signs or symptoms and response.
  • OPTION: Hospitals may also wish to assess patients’ understanding of their medications (i.e. name, dosing, purpose, side effects)

Post implementation: After piloting and fully implementing the tool kit, data should be collected and reported on a monthly basis using data sheets.

In this project, for example, a run chart could display length-of-stay averages or rehospitalization rates on a monthly basis.

• Length of stay — Monthly average among general medicine patients for the subsequent 6 months.
• Rehospitalization rate — Monthly average among general medicine patients for the subsequent 6 months.
• Discharge summary — Completion rate within 48 hours of discharge.
• Patient satisfaction — Monthly average among general medicine patients for the subsequent 6 months.
• Patient or caregiver understanding.
• Implementation rate of the discharge tool kit.