Degree Name
Nursing Practice, DNP
Publication Date
6-22-2025
First Advisor
Lisa Drake
Second Advisor
Kristie Givens
Abstract
A significant gap in standardized discharge procedures was identified at a nonprofit, community-based clinic serving male residential patients with substance use disorder (SUD) and co-occurring mental health conditions. The lack of a standardized discharge process led to poor follow-up appointment adherence, poor medication adherence and increased risk of relapse. This quality improvement (QI) project aimed to address these issues through the implementation of a cross-departmental discharge process that produced tailored Individualized Discharge Plans (IDP) or each patient, using the Donabedian and Kotter’s 8-Step Change models as guiding frameworks. Data were collected using custom-built tracking tools over two four-week periods, pre- and post-implementation. A retrospective chart review provided baseline measures, while prospective captured post-intervention outcomes. A chi-square test showed a significant improvement in follow-up appointment adherence from 33.3% to 58.3% (p = .04). Medication adherence improved from 71.4% to 79.2% (p = .55), and relapse rates declined from 19.0% to 4.2% (p = .17). Results suggest that structured discharge planning enhances continuity of care and promotes early recovery engagement in high-risk, co-occurring populations, who are particularly vulnerable to relapse and treatment disengagement. This project supports scalability across similar clinical environments and highlights how internal collaboration, and existing resources can yield measurable improvements in patient outcomes without significant cost.
Rights Management
This work is licensed under a Creative Commons Attribution 4.0 International License.
Recommended Citation
Phillips, Margaret, "Improving Patient Outcomes Post-Discharge: Implementing Evidence-Based Discharge Planning for High-Risk Mental Health and Substance Use Disorder Populations" (2025). Doctor of Nursing Practice Projects. 183.
https://arch.astate.edu/dnp-projects/183
