Discharge planning scale: community physicians' perspective

Abstract

Background: Adverse events occur when patients transition from hospital to outpatient care. For quality improvement and research purposes, clinicians need appropriate, reliable, and valid survey instruments to measure and improve discharge processes.

Objective: The objective of this study was to validate the Modified Physician-PREPARED scale to measure qualities of hospital discharge from the outpatient physician perspective. Descriptions include item development and psychometric properties.

Methods: The design was a postal survey of outpatient physicians/practitioners who followed 403 patients who were discharged from hospital to home. We mailed questionnaires 10 days after discharge. Questionnaire items assessed perceptions of quality and outcome of discharge planning and communication. Analysis yielded the Modified Physician-PREPARED scale value: the sum of scores from 8 items. Internal consistency and construct validity were assessed.

Results: Survey response rate was 76%. Mean Modified Physician-PREPARED scale value was 16.6 +/- 4.0 with range 8 to 24. High scores reflected high perceptions of discharge quality. Analysis identified 2 principal components: timeliness of communication, and adequacy of discharge plan/transmission. The scale had acceptable internal consistency (Cronbach's alpha 0.86) and construct validity. When considering the discharge planning and communication for a specific patient, outpatient primary care physicians reported higher scores when they were involved in the discharge planning (P < 0.001) and when they were aware of community support services (P = 0.002).

Conclusions: The Modified Physician-PREPARED scale measured outpatient physician perceptions of quality of hospital discharge to home. Clinicians and researchers may find the scale useful to evaluate discharge processes.

Trial registration: ClinicalTrials.gov NCT00101868.