Psy. D., Antioch University, 2018, Antioch New England: Clinical Psychology

This mixed method study piloted a newly developed tool for monitoring preparedness among youth discharged from New Hampshire Hospital (NHH) and explored its influence on hospital discharge planning and follow-up care. This study spotlighted psychosocial variables in readmission risk for a psychiatric population and introduced a conceptualization of preparedness that included patient understanding of their discharge plan, as well as hope for change and supportive relationships. Quantitative methods were used to examine the relationship between aftercare and hospital readmission and further to explore the relationship between patient preparedness and readmission, as well as adverse events experienced post-discharge. Qualitative methods were used to explore the feasibility and utility of the preparedness tool. Chi-square results indicated that aftercare was associated with reduced readmission risk at 90-days. Regression analyses indicated preparedness scores did not contribute to the prediction of adverse events and hospital readmission. The Preparedness Assessment Tool's (PAT) three-point rating scale made it difficult to detect a statistically meaningful relationship between preparedness and these outcomes and to effectively track changes in preparedness over time. Overall, the Aftercare Coordinator (AC) considered the PAT to be an invaluable asset to her work with patients. The PAT was found to be user-friendly, modifiable, effective, and efficient. Further, it helped personalize care, guide interventions, increase patient and family collaboration and understanding, and help monitor progress and patient need.

Committee: James Fauth PhD (Committee Member); Vince Pignatiello PsyD (Committee Member); Michelle Mattison PsyD (Committee Member) Subjects: Clinical Psychology