Background: Patients in Acute Medical care Units (AMUs) often encounter complex discharge processes due to rapid turnover and acute care demands. The Advanced Clinical Practice Nurse-led Discharge management and Education (ADIEU) program was developed to address these challenges and improve post-discharge outcomes. In this study, we aimed to evaluate the effectiveness of the ADIEU program on clinical outcomes and satisfaction among patients and healthcare providers.
Methods: In this retrospective study, we compared patients discharged from the AMU between January 1 and December 31, 2023, after the ADIEU program implementation, with those discharged in 2022 before the program. The Propensity Score Matching (PSM) was applied using age, sex, the Charlson Comorbidity Index (CCI), and reason for admission as matching variables to balance the groups. After matching, Thirty-day readmissions and unexpected emergency room (ER) visits within 72 hours were evaluated after matching. Subsequently, patient and healthcare personnel satisfaction were separately assessed.
Results: A total of 139 patients remained in each group after PSM. The ADIEU program significantly reduced the risk of the 30-day readmissions (OR = 0.333, 95% CI: 0.154–0.720, p = 0.005). However, no significant reduction was observed in unexpected ER visits within 72 h. Satisfaction with discharge management improved among nurses and physicians, with mean scores increasing from 3.09 to 3.43 and 3.67 to 4.67, respectively. Notably, patient satisfaction increased, with an average score of 4.81 out of 5 in post-program surveys.
Conclusions: The ADIEU program effectively reduced 30-day readmissions and increased satisfaction among healthcare providers and patients. The program represents a promising model for enhancing discharge management in AMUs despite its low impact on short-term ER visits. Therefore, it warrants further exploration in larger, multicenter studies.
