Do hospital size, location, and teaching status matter? Role of context in the use of evidence-based discharge practices

ABSTRACT

Background: In the manufacturing and service-sector industries, organizational characteristics associated with the use of innovation are well studied. This same study has not been applied to hospitals. The objective of this study was to find out whether size, location or teaching status have a relationship to the use of evidence-based hospital discharge practices. These practices were defined by Project RED (Re-Engineered Discharge), a set of practices which have been significantly associated with improved patient and hospital outcomes.

Methods: A survey measuring the use of evidence-based discharge practices, based on Project RED, was administered to all 143 acute care hospitals in Ontario, Canada and 79 hospitals responded (55% participation rate). Multiple regression analysis was used to examine the relationship between survey score and the hospitals’ location, size, and teaching status.

Results: This study found that smaller hospitals in rural locations had significantly greater use of evidence-based discharge practices. Teaching status was not found to be significantly related to the use of these practices.

Conclusion: There is a need to investigate how the characteristics of size and location influence the uptake of evidence-based practices. Smaller hospitals may benefit from fewer levels of management, and more direct communication between staff, physicians, and managers.

KEYWORDS:

• Hospitals
• evidence-based practice
• health care survey
• hospital size
• teaching hospitals
• rural hospitals

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability for this study

https://dataverse.scholarsportal.info/privateurl.xhtml?token=be60d37d-2ff7-4816-8cb7-93e1c24f963b

Additional information

Funding

This work was supported by the Canadian Institutes of Health Research under a Doctoral Research Award (Institute of Health Services and Policy Research) [number 72047152].

Notes on contributors

Jennifer Innis

Jennifer Innis is a professor in nursing at Centennial College and a nurse practitioner with the trauma/neurosurgery program at St. Michael’s Hospital in Toronto, Canada. Her research has been in the areas of health literacy and hospital discharge.

Jan Barnsley

Jan Barnsley is an associate professor with the Institute of Health Policy, Management and Evaluation at the University of Toronto. Her research interests are in the areas of performance measurement, program evaluation and health services delivery.

Whitney Berta

Whitney Berta is a Professor with the Institute of Health Policy, Management and Evaluation at the University of Toronto. Her research is focused on organizational learning and knowledge transfer.

Imtiaz Daniel

Imtiaz Daniel is an Adjunct Lecturer with the with the Institute of Health Policy, Management and Evaluation at the University of Toronto. In addition, he is the director of financial analytics and system performance at the Ontario Hospital Association.