Early identification of complex discharge planning needs: Testing the predictive validity of a screening tool

2.50
Hdl Handle:
http://hdl.handle.net/10755/158787
Type:
Presentation
Title:
Early identification of complex discharge planning needs: Testing the predictive validity of a screening tool
Abstract:
Early identification of complex discharge planning needs: Testing the predictive validity of a screening tool
Conference Sponsor:Midwest Nursing Research Society
Conference Year:2001
Author:Holland, Diane
P.I. Institution Name:Mayo Clinic
Contact Address:200 First Street, SW, Rochester, MN, 55905, USA
Contact Telephone:507.284.2511
Despite efforts to reduce variance in discharge planning, a subgroup of patients requiring “complex” discharge planning services is evident. This subgroup is described as chronically ill, functionally impaired, having little caregiver support, and at risk for poor outcomes (e.g., prolonged lengths of stay and unplanned discharge dispositions). Unfortunately, early identification of this subgroup remains elusive. The purpose of this study was to test the predictive validity of a published screen (PraTM)designed to identify persons at risk for readmissions, and including variables of interest in complex discharge planning. Using a prospective design and systematic sampling, 1000 subjects aged 21-101 were enrolled at a Midwest tertiary center. Chi-square, Wilcoxon rank sum, stepwise logistic regression, and ROCs were employed to analyze the data. Although admission PraTM scores differentiated those who received complex discharge planning (p < 0.001), the small difference in mean scores with wide, overlapping ranges renders limited clinical utility. PraTM scores did not predict either prolonged length of stay or disposition. Interestingly, the greatest AUC was obtained for self-rated health against complex discharge (.683) and dispositon (.671). Future research will investigate whether other clinical variables, when combined with self-rated health, demonstrate enhanced sensitivity and specificity for identifying need for complex discharge planning.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Midwest Nursing Research Society

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleEarly identification of complex discharge planning needs: Testing the predictive validity of a screening toolen_GB
dc.identifier.urihttp://hdl.handle.net/10755/158787-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Early identification of complex discharge planning needs: Testing the predictive validity of a screening tool</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Midwest Nursing Research Society</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2001</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Holland, Diane</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Mayo Clinic</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">200 First Street, SW, Rochester, MN, 55905, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">507.284.2511</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">holland.diane@mayo.edu</td></tr><tr><td colspan="2" class="item-abstract">Despite efforts to reduce variance in discharge planning, a subgroup of patients requiring &ldquo;complex&rdquo; discharge planning services is evident. This subgroup is described as chronically ill, functionally impaired, having little caregiver support, and at risk for poor outcomes (e.g., prolonged lengths of stay and unplanned discharge dispositions). Unfortunately, early identification of this subgroup remains elusive. The purpose of this study was to test the predictive validity of a published screen (PraTM)designed to identify persons at risk for readmissions, and including variables of interest in complex discharge planning. Using a prospective design and systematic sampling, 1000 subjects aged 21-101 were enrolled at a Midwest tertiary center. Chi-square, Wilcoxon rank sum, stepwise logistic regression, and ROCs were employed to analyze the data. Although admission PraTM scores differentiated those who received complex discharge planning (p &lt; 0.001), the small difference in mean scores with wide, overlapping ranges renders limited clinical utility. PraTM scores did not predict either prolonged length of stay or disposition. Interestingly, the greatest AUC was obtained for self-rated health against complex discharge (.683) and dispositon (.671). Future research will investigate whether other clinical variables, when combined with self-rated health, demonstrate enhanced sensitivity and specificity for identifying need for complex discharge planning.</td></tr></table>en_GB
dc.date.available2011-10-26T21:23:47Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T21:23:47Z-
dc.description.sponsorshipMidwest Nursing Research Societyen_GB
All Items in this repository are protected by copyright, with all rights reserved, unless otherwise indicated.