Discharge readiness from rehabilitation: A systematic review

Kate Gledhill, Lisa Hanna, Rebecca Nicks, Natasha A. Lannin

Research output: Contribution to journalMeeting Abstractpeer-review

Abstract

Introduction/rationale
The Australian health system is experiencing an increased demand for rehabilitation hospital beds. As a result, there is more pressure to reduce length of stay. Occupational therapists play a key role in discharge planning and assessment in preparation for discharge readiness. Yet, determining readiness for discharge is complex. Minimizing time in hospital to reduce admission-related complications is ideal; however, too early discharge may lead to poor functional and medical outcome, and potentially costly hospital re-admission. Further, it remains unknown how valid the occupational therapist's determination of “safe for discharge” really is.

Objectives
This systematic review aimed to synthesize the literature to determine stakeholders’ definitions of discharge-readiness and timing of optimal discharge from inpatient rehabilitation.

Approach
Using systematic review methodology, databases were searched using key terms and concepts. Title and abstracts were screened for eligibility and inclusion/exclusion criteria applied by one author; full texts were screened by three authors. Twenty articles were appraised for quality by two authors using the Downs and Blacks checklist and McMaster Critical Assessment for Qualitative studies. A narrative review was conducted due to the methodological heterogeneity of the studies found.

Practice implications
There remains a lack of literature, internationally, which defines discharge-readiness from rehabilitation from the perspectives of all stakeholders. The located studies discussed aspects of discharge planning from perspectives of clinicians, families or patients separately, and we located no studies that discussed discharge readiness from the management perspective. The overarching themes from our narrative synthesis were using functional outcomes as a predictor of length of stay and discharge destination, understanding the support needs of patients and identifying the barriers to discharge.

Conclusion
This systematic review identified a clear gap in the literature in defining discharge-readiness from all stakeholders’ perspectives which should be explored in further research.
Original languageEnglish
Pages (from-to)4
Number of pages1
JournalAustralian Occupational Therapy Journal
Volume66
Issue numberS1
DOIs
Publication statusPublished - Jul 2019
EventOccupational Therapy Australia National Conference and Exhibition 2019: Together Towards Tomorrow - International Convention Centre, Sydney, Australia
Duration: 10 Jul 201912 Jul 2019
Conference number: 28th
http://www.otaus2019.com.au/events/occupational-therapy-australia-28th-national-conference-and-exhibition-2019/event-summary-de4c35633e774e10beab607c7ad481cf.aspx

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