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FAQ: Magnet Multisite Study

Magnet® organizations are invited to submit expressions of interest to participate in a three-year multisite research study on evaluating discharge readiness. The Call for Expressions of Interest provides a brief overview of the study, benefits of participating, requirements for participating organizations, and instructions for submitting expressions of interest.

The following FAQs provide additional details.

ANCC Multisite Research Studies
Goals
Background
Funding Model
ANCC Agreement with Research Team
ANCC Agreements with Participating Magnet Organizations

New Multisite Study: 
READI – Readiness Evaluation and Discharge Interventions

Study Selection
RN Site Coordinator Responsibilities
Research Team
Executive Summary

ANCC Multisite Research Studies

Goals
ANCC's goal for commissioning independent multisite research studies is to provide opportunities for Magnet® organizations to be involved in rigorous, large-scale research studies that:

  • contribute to science
  • build research capacities within and across organizations
  • mentor staff in the conduct of research
  • promote networking and collaboration
  • facilitate the ability of organizations to meet the research standards for sustaining Magnet Recognition

Background
The first ANCC multisite study tested the feasibility of using a pay-to-participate model to fund the research. That initiative was successful. Forty Magnet organizations completed the study on improving heart failure outcomes conducted by Robin Newhouse, Principal Investigator, and an interdisciplinary team of researchers from the University of Maryland and Johns Hopkins.

Funding Model
Funding for ANCC multisite research studies is provided through participation fees. There is no outside funding support. The fee amount per organization is set to provide the research budget. A small additional amount is allocated to cover the costs ANCC incurs to organize and coordinate the study and covers direct expenses only. ANCC, a nonprofit 501(c)6 organization, provides multisite research studies as a service to the Magnet community; no additional revenue is generated.

ANCC Agreement with Research Team
ANCC commissions the selected research team by separate agreement to conduct the independent research studies. ANCC has no role in the conduct of a multisite study except to monitor its progress and is not in possession of any study data at any time.

ANCC Agreements with Participating Magnet Organizations
ANCC's agreements with Magnet organizations that enroll in a multisite study specify a payment schedule for the participation fees, which are collected in annual installments to permit organizations to spread the cost across fiscal years.

New Multisite Study:
READI - Readiness Evaluation and Discharge Interventions

Study Selection
The READI study was selected through a two-stage scientific review process. In September 2012, ANCC issued a call for concept papers. In February 2013, the authors of five selected concept papers were invited to submit full proposals.

RN Study Coordinator Responsibilities
Participating Magnet organizations will be asked to designate an RN study coordinator who will spend about 0.20 FTE on study procedures for 24-27 months. The responsibilities of the RN study coordinator include:

  • Serving as master trainer for unit nurses
  • Formalizing logistics of implementation procedures and data collection operations
  • Coordinating IRB application and approval process
  • Coordinating retrieval of patient characteristic and post-discharge utilization data
  • Disseminating hospital specific results within the study site

Research Team

  • Principal Investigator Marianne Weiss, DNSc, RN, Associate Professor and Wheaton Franciscan Healthcare, St. Joseph / Sister Rosalie Klein Professor of Women's Health, Marquette University College of Nursing
  • Olga Yakusheva, PhD, Associate Professor, Marquette University College of Business and Graduate School of Management, Department of Economics
  • Kathleen Bobay, PhD, RN, NEA-BC, Associate Professor, Marquette University College of Nursing
  • Ronda Hughes, PhD, RN, FAAN, Associate Professor, Marquette University College of Nursing
  • Linda Costa, PhD, RN, NEA-BC, Assistant Professor, University of Maryland, Baltimore
  • Consultant Mary A. Blegen, RN, PhD, FAAN, Professor Emerita, School of Nursing, University of California, San Francisco
  • Consultant Douglas R. Wholley, PhD, Professor, Department of Health Policy and Management, School of Public Health, University of Minnesota

Executive Summary
READI (Readiness Evaluation And Discharge Interventions):
Implementation as a Standard Nursing Practice for Hospital Discharge

Preparation of patients for discharge is a primary function of hospital-based nursing care and readiness for discharge is an important outcome of hospital care. Inadequacies in discharge preparation have been well-documented and linked to difficulty with self-management after hospital discharge and with increased likelihood of emergency department (ED) use and readmission. Prior studies by the research team have led to recommendations for implementation of discharge readiness assessment as a standard nursing practice for hospital discharge.

This study aims to test the impact of unit-based implementation of discharge readiness assessment on readmission and ED use within 30 days post-discharge. Three protocols, each adding a component to discharge readiness assessment, will be used to introduce, in sequence: (1) discharge readiness assessment by the discharging nurse; (2) discharge readiness assessment by the discharging nurse informed by prior patient self-report of discharge readiness; and (3) patient-informed nurse assessment, with the addition of an instruction to the discharging nurse to initiate and document nursing action(s) for patients with low readiness. Nurse and patient versions of the 8-item short form of the Readiness for Hospital Discharge Scale will be used for discharge readiness assessment.

The study will use a prospective, parallel cohort, stepped intervention design with four study steps (baseline and the 3 intervention steps) and two study conditions (implementation units and usual care control units). Difference-in-difference analysis will compare patient outcomes at baseline and each of the 3 implementation steps on the intervention units (first difference) to outcomes on paired control units (second difference), adjusting for hospital, unit, and patient-level control variables. The optimal implementation protocol will be identified through these methods. Cost-benefit analysis will calculate the net economic benefit of effects on post-discharge utilization outcomes, adjusting for recurring and non-recurring implementation costs. The results will provide evidence of the impact of a hospital nursing care process on postdischarge outcomes, with important implications for patient well-being and costs of care. Process evaluation will assess intervention fidelity and implementation context, facilitating broad translation as a standard of nursing practice for hospital discharge.