Date of Conferral

11-5-2025

Date of Award

November 2025

Degree

Doctor of Healthcare Administration (D.H.A.)

School

Management

Advisor

Miriam Ross

Abstract

Hospital discharge planning is a critical determinant of patient outcomes, organizational performance, and financial sustainability. Many non-teaching urban hospitals continue to struggle with high readmission rates, especially among socially vulnerable populations such as the homeless. The purpose of this integrative review was to examine discharge planning strategies that would reduce readmissions, enhancing patient throughput, and mitigating financial penalties in non-teaching urban hospitals. The review question focused on effective discharge planning strategies that would improve readmission rates in non-teaching urban hospitals. A systematic integrative review of peer-reviewed studies published between 2020 and 2025 was conducted and 25 quantitative and qualitative studies were appraised using the Johns Hopkins Evidence-Based Practice model to assess quality and strength of evidence. Coleman and Boult’s transitions of care theory provided the conceptual framework to guide thematic analysis and synthesis. Five overarching themes and fourteen subthemes emerged: standardized discharge processes, patient-centered communication, risk identification, social support integration, and outcome monitoring. Evidence demonstrated that structured discharge protocols, interdisciplinary collaboration, early risk stratification, and social support services may reduce readmissions and improved care transitions. Findings suggested that non-teaching urban hospitals can enhance quality and financial performance by embedding evidence-based discharge practices that align with transitions of care principles and positive social change. Practical applications include standardized checklists, leveraging predictive analytics, strengthening social work integration, and using quality improvement measures to reduce readmissions and penalties while improving patient outcomes.

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