The Development of a Discharge Planning System for Patients with Uncontrolled Type 2 Diabetes Using the IDEAL Model Framework in the Inpatient Ward, Thung Khao Luang Hospital

Abstract

Purposes: This study aimed to investigate the situation, develop a system, and evaluate a discharge planning model for patients with uncontrolled type 2 diabetes mellitus (T2DM) using the IDEAL Model at the inpatient ward of Thung Khao Luang Hospital.

Study Design: Participatory Action Research (PAR).

Materials and Methods: The study included two groups of key informants: (1) eight registered nurses working in the inpatient ward, and (2) twenty patients with T2DM who were hospitalized due to hypoglycemia or hyperglycemia. Additionally, twenty-four participants were involved as co-researchers. Data collection tools included focus group discussion guides, a feasibility assessment form, and a discharge protocol compliance checklist. Data were analyzed using frequency, percentage, mean, standard deviation, and content analysis.

Main finding: 1) The situational analysis revealed several challenges across four areas: patients and caregivers, service systems, healthcare providers, and medical equipment and supplies. 2) The development process resulted in a discharge planning manual for patients with uncontrolled T2DM, comprising five key steps: (1) identifying a primary caregiver, (2) conducting in-depth discussion of problems, (3) providing targeted education, (4) assessing patient knowledge, and (5) active listening. And 3) Regarding outcomes, the unplanned hospital readmission rate within 28 days was reduced to 15.0%, a statistically significant result, indicating the effectiveness of a discharge planning model that addresses both clinical and psychosocial aspects.

Conclusion and Recommendations: The findings demonstrate that the IDEAL Model significantly enhanced the quality of discharge planning and patient understanding across multiple dimensions, particularly in communication and preparedness for discharge. Notably, none of the patients who completed all five IDEAL components were readmitted, affirming the model’s clinical utility. The study recommends its adoption as a standard discharge planning approach for patients with uncontrolled diabetes in community hospitals.