Date of this Version


Document Type

DNP Project




Transition of care is the transfer of a patient from one care setting to another. Patient safety is paced in a susceptible position with the modification of their care setting and team due in part to the potential loss of critical clinical material and communication. Formal transitional care programs permit a connection between clinical settings and providers. Lack of a formal standardized discharge summary can negatively impact patient care for kidney recipients during the transitional process from inpatient hospitalizations back to the community provider by adversely impacting provider satisfaction and breaking the continuity in patient care. Purpose: This quality improvement program aims to streamline the discharge process for renal transplant recipients in an urban academic hospital transitioning to the outpatient setting, by implementing a transplant discharge template. Methodology: Setting: An academic urban county hospital located in South Florida. Participants: Kidney Transplant Division inpatient nurse practitioners, the coordinators, and the outpatient nurse practitioners, physician assistants, physicians, and the coordinators. Approach and Project Procedure: Development of a discharge template, with education on its use and implementation. Instruments and Tools: Measurements of the perceived provider satisfaction and comprehension of the discharge summary will be obtained through questionnaires, a Pre- and Post-survey. Data Analysis: performed using the Statistical Package for Social Sciences (SPSS). A paired t-test was used to perform the comparison. Timeline: 6- 8 weeks. Findings: Comparing the results of the pretest and post-test, one can determine whether the implementation of the tool had a significant impact on the intended outcome. Results for this project include an increase in communication between the inpatient and outpatient team. Discussion: The doctoral student found an improvement in communication between the inpatient and outpatient providers. Provider satisfaction did not show any statically significant change, feedback from participants indicated an improvement in their workflow, time management, and better communication on the plan of care for the patients through the implementation of a formal discharge template. These results correlate with studies showing the improvement in provider satisfaction through better communication. The study results support the effectiveness of a standardized process in the workplace.

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