Improving the satisfaction and readiness of chronic disease patients through the use of IDEAL discharge planning

Main Article Content

Ahsan
Ike Nesdia Rahmawati
Evi Harwiati Ningrum
Rizal Salsabila
Nacita Salma Tevyveda
Tibyani
Wada Chikamune
Kumoro Asto Lenggono

Abstract

Introduction: Effective discharge planning is critical for ensuring continuity of care and improving outcomes for patients with chronic diseases. This study explores the implementation of the IDEAL discharge planning strategy—Involve, Discuss, Educate, Assess, and Listen—to enhance patient satisfaction and readiness for discharge. A quasi-experimental design was employed, involving chronic disease patients from a tertiary care hospital. The intervention group received discharge planning based on the IDEAL framework, while the control group received standard discharge procedures. Outcomes were measured using validated tools assessing patient satisfaction and readiness for discharge.


Results: The results of the study showed that there was a positive and significant difference between the intervention group and the control group with a p-value of 0.000 <0.05, which means that there is a difference in patient readiness to go home between the intervention group with IDEAL Discharge Planning treatment and with Discharge planning treatment in the control group.


Discussion: Indicated a statistically significant improvement in both satisfaction and readiness scores among patients in the IDEAL group compared to the control group. Patients reported feeling more informed, involved in their care, and confident in managing their condition post-discharge. These findings suggest that structured, patient-centered discharge planning can play a pivotal role in improving the transition from hospital to home for individuals with chronic illnesses.


Conclusion: The study underscores the importance of adopting comprehensive discharge planning models like IDEAL to foster better patient outcomes and reduce readmission rates. Further research is recommended to explore long-term impacts and scalability across diverse healthcare settings

Article Details

Section
Research Articles

References

[1] (AHRQ), A. for HR and Q. (2023). IDEAL Discharge Planning: Implementation Handbook. Retrieved from https://www.ahrq.gov/patient-safety/settings/hospital/ideal-discharge/index.html

[2] Aboumatar, H.J., Naqibuddin, M., Chung, S., Chaudhry, H., Kim, S.W., Saunders, J., & Pronovost, P. (2021). Effect of a program combining transitional care and long-term self-management support on outcomes of hospitalized patients with chronic obstructive pulmonary disease: A randomized clinical trial. JAMA Network Open, 4(3), e210935. https://doi.org/10.1001/jamanetworkopen.2021.0935

[3] Andreas, E., Era, DP, & Hidayat, A. (2023). The Effect of Discharge Planning on Readiness to Go Home in Patients with Kidney Stones at RSD dr. H. Soemarno Sosroatmodjo. SAINTEKES: Journal of Science, Technology and Health, 2(3), 312–323.

[4] Astuti, F., Suhartono, S., & Sulisno, M. (2016). The effect of ideal discharge planning on self-care ability of diabetes mellitus patients: a study on diabetes mellitus patients at Mataram City Hospital and NTB Provincial Hospital. Diponegoro University.

[5] Barrett, J.B., Trambley, A., Blessinger, E.K., Sexton, M.M., Lupica, M., Hasselblad, M., … Choma, N.N. (2025). Reduced Hospital Readmissions Through Personalized Care: Implementation of a Patient, Risk-Focused Hospital-Wide Discharge Care Center. NEJM Catalyst Innovations in Care Delivery, 6(6), CAT-24.

[6] Burns, S.T., Amobi, N., Chen, J.V., O'Brien, M., & Haber, L.A. (2022). Readability of Patient Discharge Instructions. Journal of General Internal Medicine, 37(7), 1797–1798. https://doi.org/10.1007/s11606-021-06988-y

[7] Chang, E., & Johnson, A. (2013). Chronic illness and disability: Principles for nursing practice. Elsevier Health Sciences.

[8] Chang, J., Hou, W.-W., Wang, Y.-F., & Sun, Q.-M. (2020). Main risk factors related to activities of daily living in non-dialysis patients with chronic kidney disease stages 3–5: A case–control study. Clinical Interventions in Aging, 609–618.

[9] Datuela, N., Riu, SDM, & Yahya, IM (2022). The Effect of Discharge Planning Model Lima on Patient Readiness to Go Home at Class II Robert Wolter Mongisidi Hospital, Manado City. Amanah Health Journal, 6(1), 60–65.

[10] Galvin, E.C., Wills, T., & Coffey, A. (2017). Readiness for hospital discharge: A concept analysis. Journal of Advanced Nursing, 73(11), 2547–2557.

[11] Hariyanti, T., Fitriasari, N., Pradana, EW, & Lenggono, KA (2024). Hospital Customer Competition Issues are being addressed through Confirmation Factor Analysis on Experiential Marketing, Brand Trust, and Loyalty. The Open Public Health Journal, 17(1).

[12] Harleni, H., Yanti, R., & Wahyu Diana, N. (2022a). The Effect of Health Education Using the Brainstorming Booklet and Leaflet Method on the Knowledge and Attitudes of Mothers of Stunting Toddlers at the Malalak Health Center in 2021. Encyclopedia of Journal, 4 (3), 148–158. Encyclopedia of Journal, 4 (3), 148–158.

[13] Harleni, H., Yanti, R., & Wahyu Diana, N. (2022b). The Effect of Health Education with the Brainstorming Booklet and Leaflet Method on the Knowledge and Attitudes of Mothers of Stunting Toddlers at the Malalak Health Center in 2021. Encyclopedia of Journal, 4(3), 148–158. https://doi.org/10.33559/eoj.v4i3.1051

[14] Heron, M. (2016). National Vital Statistics Reports Deaths: leading causes for 2013. National Vital Statistics Reports: From the Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System, 65(2), 1–95. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/18092547

[15] Hestevik, C. H., Molin, M., Debesay, J., Bergland, A., & Bye, A. (2019). Older persons' experiences of adapting to daily life at home after hospital discharge: a qualitative metasummary. BMC Health Services Research, 19, 1–13.

[16] Jack, B. W., Austad, K., Renfro, D. R., & Mitchell, S. (2023). Re-Engineering the Hospital Discharge to Improve the Transition From Hospital to Home. Journal of Healthcare Management Standards, 3(1), 1–17. https://doi.org/10.4018/jhms.328775

[17] Jaganathan, S. P., Conway, G., & Dunlap, S. (2017). Effective Discharge Planning BT - Short Stay Management of Acute Heart Failure (WF Peacock, Ed.). https://doi.org/10.1007/978-3-319-44006-4_18

[18] Kable, A.K., Chenoweth, L., Pond, D., & Hullick, C. (2019). Health professional perspectives on systems failures in transitional care for patients with dementia and their carers: A qualitative descriptive study. BMC Health Services Research, 19(1), 459. https://doi.org/10.1186/s12913-019-4307-7

[19] Kaya, S., & Karaca, A. (2020). The effect of discharge training with booklet on self-efficacy and the status of patients with heart failure: A randomized controlled trial. Clinical Nursing Research, 29(5), 335–342. https://doi.org/10.1177/1054773819834629

[20] Lenggono, KA, Qomariyatus, S., Gatot, C., Sri, A., Patria, DKA, & Adi, S. (2023). Discipline as complete mediation in the implementation of the Theory Planned Behavior of nurse's handwashing compliance. The Medical Journal of Malaysia, 78(3), 296–300.

[21] Li, L., Ma, Z., & Wang, W. (2020). Influence of transitional care on the self-care ability of kidney transplant recipients after discharge. Annals of Palliative Medicine, 9(4), 1951964–1958964.

[22] Melnyk, B. M., & Fineout-Overholt, E. (2022). Evidence-based practice in nursing & healthcare: A guide to best practice. Lippincott Williams & Wilkins.

[23] Michalski, P., Kasprzak, M., Siedlaczek, M., & Kubica, A. (2020). The impact of knowledge and effectiveness of educational intervention on readiness for hospital discharge and adherence to therapeutic recommendations in patients with acute coronary syndrome. Medical Research Journal, 5(2), 72–78. https://doi.org/10.5603/mrj.a2020.0023

[24] Mirza, K. (2022). POSTNATAL NURSING CARE FOR PATIENT Mrs. A WITH CAESARIAL SECTION IN BAITUNNISA 2 ROOM, SULTAN AGUNG ISLAMIC HOSPITAL, SEMARANG. Sultan Agung Islamic University, Semarang.

[25] Mitchell, S. E., Weigel, G. M., Laurens, V., Martin, J., & Jack, B. W. (2018). Implementation and effectiveness of the IDEAL discharge planning in diverse populations: A systematic review. Journal of Hospital Medicine, 13(6), 408–415. https://doi.org/10.12788/jhm.2896

[26] Muwakhidah, M., Fatih, FD, & Primadani, T. (2021). The Effectiveness of Education with Booklet, Leaflet and Poster Media on Knowledge of Anemia in Adolescent Girls. Proceeding of The URECOL, 438–446.

[27] Ningrum, EH, Rahmawati, IN, Putra, KR, Ahsan, A., Insyirah, AA, & Afri, B. (2023). Improving Stroke Patient Knowledge Through the Implementation of the Patient Friend Application. TRI DHARMA MANDIRI: Dissemination and Downstreaming of Research to the Community (Journal of Community Service), 3(1), 44–51.

[28] Pahlevani, M., Taghavi, M., & Vanberkel, P. (2024). A systematic literature review of predicting patient discharges using statistical methods and machine learning. Health Care Management Science, 27(3), 458–478. https://doi.org/10.1007/s10729-024-09682-7

[29] Pahria, T., Nugroho, C., & Yani, DI (2022). Factors influencing self-care behaviors in hypertension patients with complications. Vascular Health and Risk Management, 463–471.

[30] Qian, J., Qian, M., Ren, Y., Ye, L., Qian, F., Jin, L., … Xu, H. (2021). Readiness for hospital discharge and influencing factors: a cross-sectional study on patients discharged with tubes from the department of hepatobiliary surgery. BMC Surgery, 21, 1–10.

[31] Rahmawati, IN, Noviyanti, LW, & Lenggono, KA (2024). A Safety Model for Preventing Nosocomial Infections in Stroke Patients. The Open Public Health Journal, 17(1).

[32] Rathert, C., Wyrwich, M.D., & Boren, S.A. (2019). Patient-centered care and outcomes: A systematic review of the literature. Medical Care Research and Reviews, 76(1), 3–23. https://doi.org/10.1177/1077558715771272

[33] RIZKI, NH (2021). The Influence of Health Education on the Level of Knowledge and Discharge Preparation of Post-Nephrolithotomy Patients at RSI Sultan Agung Semarang. Sultan Agung Islamic University Semarang.

[34] Rosymida, I. (2018). Description of health education conducted by nurses at the Polyclinic of Dr. Kariadi General Hospital Semarang. Muhammadiyah University of Semarang.

[35] Sasono, HA, Husna, I., Zulfian, Z., & Mulyani, W. (2021). The relationship between education level and the incidence of anemia in pregnant women in several regions of Indonesia. Jurnal Medika Malahayati, 5(1), 59–66.

[36] Sharma, P., Maurya, P., & Muhammad, T. (2021). Number of chronic conditions and associated functional limitations among older adults: cross-sectional findings from the longitudinal aging study in India. BMC Geriatrics, 21, 1–12.

[37] Subdari, DT, Anwar, R., Rasyad, AS, Wijayanegara, H., Rowawi, R., & Komalaningsih, S. (2020). The Influence of Booklet Media and Question and Answer Lecture Methods on Family Knowledge About Support for the Elderly. Journal of Health Systems, 5(4).

[38] Sumiyati, S., Widiastuti, A., Hastuti, P., Winarso, SP, & Kurniasih, H. (2023). Media booklet improves the attitude and practice of breast self-examination as early detection of breast cancer in female students. Jurnal Aisyah: Jurnal Ilmu Kesehatan, 8(2).

[39] Wang, M., Lv, L., Yu, Z., Gao, L., Lu, Q., Ou, J., & Luo, S. (2021). A cross‐sectional study of readiness for discharge, chronic illness resources and postdischarge outcomes in patients with diabetic foot ulcers. Nursing Open, 8(5), 2645–2654.

[40] Zhao, H., Feng, X., Yu, R., Gu, D., & Zhang, X. (2020). Factors influencing readiness for hospital discharge among patients undergoing laryngectomy. International Journal of Nursing Practice, 26(5), e12875..