Graumlich James F, Grimmer-Somers Karen, Aldag Jean C
Department of Medicine, University of Illinois College of Medicine, 530 NE Glen Oak Avenue, Peoria, IL 61637, USA.
J Hosp Med. 2008 Nov-Dec;3(6):455-64. doi: 10.1002/jhm.371.
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.
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.
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.
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).
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.
患者从医院过渡到门诊护理时会发生不良事件。出于质量改进和研究目的，临床医生需要合适、可靠且有效的调查工具来衡量和改进出院流程。
本研究的目的是验证改良的医师-准备就绪量表，以从门诊医生的角度衡量医院出院的质量。描述包括条目开发和心理测量特性。
设计了一项针对403名出院回家患者的门诊医生/从业者的邮寄调查。我们在出院10天后邮寄问卷。问卷条目评估了对出院计划和沟通质量及结果的看法。分析得出改良的医师-准备就绪量表值：8个条目的得分总和。评估了内部一致性和结构效度。
调查回复率为76%。改良的医师-准备就绪量表的平均分值为16.6±4.0，范围为8至24。高分反映出对出院质量的高度认可。分析确定了2个主要成分：沟通的及时性以及出院计划/传递的充分性。该量表具有可接受的内部一致性（克朗巴哈α系数为0.86）和结构效度。在考虑特定患者的出院计划和沟通时，门诊初级保健医生在参与出院计划时（P<0.001）以及知晓社区支持服务时（P=0.002）报告的得分更高。
改良的医师-准备就绪量表测量了门诊医生对患者出院回家质量的看法。临床医生和研究人员可能会发现该量表对评估出院流程有用。
