Access Type

Open Access Dissertation

Date of Award


Degree Type


Degree Name



Curriculum and Instruction

First Advisor

Dr. Leonard Kaplan


Results and Implications The Medicare data used for the study comes from previous RAND studies and data from a sample community hospital for comparisons of average lengths of stay, post hospital utilization, characteristics of patients who have a propensity to use post hospital care by gender, age and diagnosis. The study examines how reimbursement has effected patient care management therefore changing the hospital discharge planners priorities. The activities where discharge planners spend the majority of their time were stressed the least during their collegiate preparation as rated by the discharge planners through a survey instrument. Patients are experiencing shorter hospital lengths of stay, increase use of post hospital care and discharge planners find themselves spending the majority of their time on DRG optimization/utilization management, communication, securing resources and quality care assessment which totaled 60 percent of their time in an average work week. These areas were less stressed during the discharge planners collegiate education. Only 25 percent to 63 percent of the respondents stated these activities were stressed to highly stressed during their professional education. Changes in the curriculum of registered nurses and social workers who wish to become discharge planners must occur in the areas of health care reimbursement, communication, and particularly in the area of measuring quality of care across a continuum of services. A review of university sample curriculums by title indicates that very little attention is given explicitly to proprietary content which will be driving how our health care system functions now and well into the future. One approach to educating existing staff would be to offer a standardized university curriculum and certification exam to demonstrate proficiency in the new proprietary climate. Education is regarded as a primary strategy for transitioning practitioners into the new roles created by changes occurring in how our health care services are funded.