From the Guidelines
The standard hospital disposition description options to describe a patient's current health status include seven profiles, ranging from critical cardiogenic shock to advanced NYHA class III, as outlined in the 2022 AHA/ACC/HFSA guideline for the management of heart failure 1. These profiles are used to communicate a patient's condition efficiently and prioritize care. The seven profiles are:
- Profile 1: Critical cardiogenic shock
- Profile 2: Progressive decline
- Profile 3: Stable but inotrope dependent
- Profile 4: Resting symptoms on oral therapy at home
- Profile 5: Exertion intolerant
- Profile 6: Exertion limited
- Profile 7: Advanced NYHA class III These profiles can be modified to include additional information, such as recurrent decompensations or arrhythmias, to provide a more accurate description of the patient's condition 1. The use of these standardized profiles helps to ensure continuity of care and allocate resources appropriately, especially during handoffs between healthcare teams. Key features of each profile include:
- Life-threatening hypotension and rapidly escalating inotropic/pressor support for Profile 1
- Dependence on inotropic support with signs of continuing deterioration for Profile 2
- Clinical stability on mild-moderate doses of intravenous inotropes for Profile 3
- Symptoms of congestion at rest or with activities of daily living for Profile 4
- Inability to engage in any activity due to exertion intolerance for Profile 5
- Ability to perform mild activity with fatigue resulting within a few minutes for Profile 6
- Clinical stability with a reasonable level of comfortable activity for Profile 7 These profiles provide a quick snapshot of the patient's overall condition, helping healthcare providers to prioritize care and make informed decisions about treatment and resource allocation 1.
From the Research
Hospital Disposition Description Options
The standard hospital disposition description options to describe a patient's current health status include:
- Discharge home
- Discharge to a skilled nursing facility
- Discharge to a rehabilitation facility
- Discharge to home health care
- Discharge to other facilities for continued medical or rehabilitative management 2, 3
Factors Influencing Discharge Disposition
The decision to discharge a patient to a particular facility is influenced by various factors, including:
- Insurance status 3
- Patient demographics
- Injury severity
- Availability of postacute care facilities
- Clinical decision support algorithms 4
Importance of Accurate Discharge Disposition
Accurate discharge disposition is crucial to ensure that patients receive the necessary care and support after hospitalization. Studies have shown that discharge disposition can affect patient outcomes, including readmission rates and functional outcomes 2, 4. Additionally, providing patients with written and verbal information about their discharge medication and care can improve knowledge and satisfaction 5, 6.
Discharge Disposition and Patient Outcomes
Research has demonstrated that discharge disposition can have a significant impact on patient outcomes. For example, a study found that patients who were discharged to a facility had lower readmission rates compared to those who were discharged home 4. Another study found that uninsured patients were less likely to be discharged to specialized postacute care facilities and had higher odds of being discharged directly home 3.