# Effects of an Advanced Clinical Practice Nurse-Led Discharge Management and Education Program on Patient Outcomes in an Acute Medical Care Unit (ADIEU)

## TL;DR

A nurse-led discharge program reduced 30-day readmissions and improved satisfaction in acute medical care units.

## Contribution

The ADIEU program introduces a nurse-led model for discharge management that reduces readmissions in AMUs.

## Key findings

- The ADIEU program significantly reduced 30-day readmission risk by 66.7%.
- Healthcare provider satisfaction improved after implementing the ADIEU program.
- No significant reduction in unexpected ED visits within 72 hours was observed.

## Abstract

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 postdischarge outcomes.

To evaluate the effectiveness of the ADIEU program on clinical outcomes and satisfaction among patients and healthcare providers in AMUs.

This retrospective study enrolled 360 patients discharged from the AMU of a tertiary hospital in Republic of Korea and compared them before and after ADIEU program implementation. Propensity score matching (PSM) was applied using age, sex, Charlson Comorbidity Index (CCI), and reason for admission as matching variables. After PSM, 139 patients were included in each group. Thirty-day readmissions and unexpected emergency department (ED) visits within 72 h were evaluated after PSM. Patient and healthcare personnel satisfaction were separately assessed.

The ADIEU program significantly reduced the risk of 30-day readmission (odds ratio = 0.333). However, no significant reduction in unexpected ED visits within 72 h was observed. Discharge management satisfaction improved among nurses (mean score: 3.09–3.43) and physicians (mean score: 3.67–4.67).

The ADIEU program effectively reduced 30-day readmissions and increased satisfaction among healthcare providers and patients.

The ADIEU program represents a promising model for enhancing discharge management in AMUs despite its minimal impact on short-term ED visits.