Nudging Discharge Readiness With a Poster: A Sequential, Exploratory Mixed Methods Pilot Study of Patient Caregivers
Many hospitals face a common challenge: limited space for a high number of patients. This has led to quick patient throughput, which can impact patient perception of discharge readiness. This study examined whether a poster highlighting tasks to complete as part of the discharge process improved car...
| Main Authors: | , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2020-12-01
|
| Series: | Journal of Patient Experience |
| Online Access: | https://doi.org/10.1177/2374373520968976 |
| _version_ | 1818048590110523392 |
|---|---|
| author | Laura L Leets PhD Jennifer Cahill PhD, RN Amber M Sprenger PhD Juli Simon Thomas PhD Rob Hartman PhD Mary E Poyner Reed PhD, RN, CNRN, ANP, NEA-BC Haylee Manning BS Marge Britt MS Chrissy T Vu PhD Nicholas W Kohn PhD Sandi Aguirre PhD Sanith Wijesinghe PhD Sybil Klaus MD |
| author_facet | Laura L Leets PhD Jennifer Cahill PhD, RN Amber M Sprenger PhD Juli Simon Thomas PhD Rob Hartman PhD Mary E Poyner Reed PhD, RN, CNRN, ANP, NEA-BC Haylee Manning BS Marge Britt MS Chrissy T Vu PhD Nicholas W Kohn PhD Sandi Aguirre PhD Sanith Wijesinghe PhD Sybil Klaus MD |
| author_sort | Laura L Leets PhD |
| collection | DOAJ |
| description | Many hospitals face a common challenge: limited space for a high number of patients. This has led to quick patient throughput, which can impact patient perception of discharge readiness. This study examined whether a poster highlighting tasks to complete as part of the discharge process improved caregiver perception of readiness to transition home. Using a sequential, exploratory mixed methods design, focus groups were convened to explore clinical staff perspective on the discharge process on 3 pediatric inpatient units at a large, urban, pediatric academic medical center in the United States. Analysis of this content informed the design of a poster intervention to “nudge” caregivers (eg, parents, legal guardians) toward readiness and self-efficacy that was then tested in a randomized, controlled experiment. The poster focused on practical knowledge for specific areas of transition adjustment, such as medication and care recipient recovery behaviors, barriers, and enablers. Caregivers (n = 135) completed surveys at discharge indicating their perceived readiness to transition home with their child. Analysis of covariance was used to test the effect of the poster condition (poster vs no poster) on caregiver readiness, preparedness, and confidence for discharge while controlling for previous admission history. Significant effects for poster presence were found on caregivers’ perceived readiness for discharge, F 1,125 = 7.75, P = .006, Cohen’s d = 0.44; and caregivers’ perceived preparedness for the transition home, F 1,121 =7.24, P = .008, Cohen’s d = 0.44. Only a marginal effect was found for poster condition on caregivers’ confidence ratings, F 1,125 = 2.93, P = .090, Cohen’s d = 0.29. The results suggest that simple nudges in the patient care environment may yield measurable improvements in caregiver outcomes. |
| first_indexed | 2024-12-10T10:24:06Z |
| format | Article |
| id | doaj.art-1aff78cda8794a9cba4ab821478c6471 |
| institution | Directory Open Access Journal |
| issn | 2374-3735 2374-3743 |
| language | English |
| last_indexed | 2024-12-10T10:24:06Z |
| publishDate | 2020-12-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Journal of Patient Experience |
| spelling | doaj.art-1aff78cda8794a9cba4ab821478c64712022-12-22T01:52:46ZengSAGE PublishingJournal of Patient Experience2374-37352374-37432020-12-01710.1177/2374373520968976Nudging Discharge Readiness With a Poster: A Sequential, Exploratory Mixed Methods Pilot Study of Patient CaregiversLaura L Leets PhD0Jennifer Cahill PhD, RN1Amber M Sprenger PhD2Juli Simon Thomas PhD3Rob Hartman PhD4Mary E Poyner Reed PhD, RN, CNRN, ANP, NEA-BC5Haylee Manning BS6Marge Britt MS7Chrissy T Vu PhD8Nicholas W Kohn PhD9Sandi Aguirre PhD10Sanith Wijesinghe PhD11Sybil Klaus MD12 MITRE Corporation, McLean, VA, USA Department of Nursing, Boston Children’s Hospital, Boston, MA, USA MITRE Corporation, McLean, VA, USA MITRE Corporation, McLean, VA, USA MITRE Corporation, McLean, VA, USA Department of Nursing, Boston Children’s Hospital, Boston, MA, USA Department of Nursing, Boston Children’s Hospital, Boston, MA, USA MITRE Corporation, McLean, VA, USA MITRE Corporation, McLean, VA, USA MITRE Corporation, McLean, VA, USA MITRE Corporation, McLean, VA, USA MITRE Corporation, McLean, VA, USA MITRE Corporation, McLean, VA, USAMany hospitals face a common challenge: limited space for a high number of patients. This has led to quick patient throughput, which can impact patient perception of discharge readiness. This study examined whether a poster highlighting tasks to complete as part of the discharge process improved caregiver perception of readiness to transition home. Using a sequential, exploratory mixed methods design, focus groups were convened to explore clinical staff perspective on the discharge process on 3 pediatric inpatient units at a large, urban, pediatric academic medical center in the United States. Analysis of this content informed the design of a poster intervention to “nudge” caregivers (eg, parents, legal guardians) toward readiness and self-efficacy that was then tested in a randomized, controlled experiment. The poster focused on practical knowledge for specific areas of transition adjustment, such as medication and care recipient recovery behaviors, barriers, and enablers. Caregivers (n = 135) completed surveys at discharge indicating their perceived readiness to transition home with their child. Analysis of covariance was used to test the effect of the poster condition (poster vs no poster) on caregiver readiness, preparedness, and confidence for discharge while controlling for previous admission history. Significant effects for poster presence were found on caregivers’ perceived readiness for discharge, F 1,125 = 7.75, P = .006, Cohen’s d = 0.44; and caregivers’ perceived preparedness for the transition home, F 1,121 =7.24, P = .008, Cohen’s d = 0.44. Only a marginal effect was found for poster condition on caregivers’ confidence ratings, F 1,125 = 2.93, P = .090, Cohen’s d = 0.29. The results suggest that simple nudges in the patient care environment may yield measurable improvements in caregiver outcomes.https://doi.org/10.1177/2374373520968976 |
| spellingShingle | Laura L Leets PhD Jennifer Cahill PhD, RN Amber M Sprenger PhD Juli Simon Thomas PhD Rob Hartman PhD Mary E Poyner Reed PhD, RN, CNRN, ANP, NEA-BC Haylee Manning BS Marge Britt MS Chrissy T Vu PhD Nicholas W Kohn PhD Sandi Aguirre PhD Sanith Wijesinghe PhD Sybil Klaus MD Nudging Discharge Readiness With a Poster: A Sequential, Exploratory Mixed Methods Pilot Study of Patient Caregivers Journal of Patient Experience |
| title | Nudging Discharge Readiness With a Poster: A Sequential, Exploratory Mixed Methods Pilot Study of Patient Caregivers |
| title_full | Nudging Discharge Readiness With a Poster: A Sequential, Exploratory Mixed Methods Pilot Study of Patient Caregivers |
| title_fullStr | Nudging Discharge Readiness With a Poster: A Sequential, Exploratory Mixed Methods Pilot Study of Patient Caregivers |
| title_full_unstemmed | Nudging Discharge Readiness With a Poster: A Sequential, Exploratory Mixed Methods Pilot Study of Patient Caregivers |
| title_short | Nudging Discharge Readiness With a Poster: A Sequential, Exploratory Mixed Methods Pilot Study of Patient Caregivers |
| title_sort | nudging discharge readiness with a poster a sequential exploratory mixed methods pilot study of patient caregivers |
| url | https://doi.org/10.1177/2374373520968976 |
| work_keys_str_mv | AT lauralleetsphd nudgingdischargereadinesswithaposterasequentialexploratorymixedmethodspilotstudyofpatientcaregivers AT jennifercahillphdrn nudgingdischargereadinesswithaposterasequentialexploratorymixedmethodspilotstudyofpatientcaregivers AT ambermsprengerphd nudgingdischargereadinesswithaposterasequentialexploratorymixedmethodspilotstudyofpatientcaregivers AT julisimonthomasphd nudgingdischargereadinesswithaposterasequentialexploratorymixedmethodspilotstudyofpatientcaregivers AT robhartmanphd nudgingdischargereadinesswithaposterasequentialexploratorymixedmethodspilotstudyofpatientcaregivers AT maryepoynerreedphdrncnrnanpneabc nudgingdischargereadinesswithaposterasequentialexploratorymixedmethodspilotstudyofpatientcaregivers AT hayleemanningbs nudgingdischargereadinesswithaposterasequentialexploratorymixedmethodspilotstudyofpatientcaregivers AT margebrittms nudgingdischargereadinesswithaposterasequentialexploratorymixedmethodspilotstudyofpatientcaregivers AT chrissytvuphd nudgingdischargereadinesswithaposterasequentialexploratorymixedmethodspilotstudyofpatientcaregivers AT nicholaswkohnphd nudgingdischargereadinesswithaposterasequentialexploratorymixedmethodspilotstudyofpatientcaregivers AT sandiaguirrephd nudgingdischargereadinesswithaposterasequentialexploratorymixedmethodspilotstudyofpatientcaregivers AT sanithwijesinghephd nudgingdischargereadinesswithaposterasequentialexploratorymixedmethodspilotstudyofpatientcaregivers AT sybilklausmd nudgingdischargereadinesswithaposterasequentialexploratorymixedmethodspilotstudyofpatientcaregivers |