Hospital Discharge Scales -- Quality of Discharge Teaching Scale (QDTS)
The QUALITY OF DISCHARGE TEACHING SCALE (QDTS) is a patient self-report tool that measures the patient’s perception of the quality of discharge teaching provided by nurses over the course of hospitalization in preparation for discharge. The QDTS measures the receiver characteristics (patient perspective) of the nursing care process of discharge teaching. Note that the scale asks patients to reflect on the teaching the received from their nurses over the course of hospitalization, based on an underlying assumption that discharge teaching occurs throughout the hospitalization. It was not intended to measure teaching by one specific nurse, but rather whether the patient received an adequate amount of content from nurses and whether the nurses exhibited high quality discharge teaching skills. The QDTS is administered on the day of discharge, normally within 4 hours prior to discharge.
The scale consists of 2 subscales
- Content (measuring the amount of content received)
- The content scale includes parallel questions on content received and content needed (only the received score is included in the scale calculations though subscale analysis for differences in content needed and received can be calculated).
- 6 parallel questions (needed and received) in the Adult Medical-Surgical and Parent forms and 7 parallel questions in the Postpartum Mother (OB) form.
- Delivery (the skills of nurses in delivering the discharge teaching).
- 13 items
- Note: prior versions of the scale had 12 items. In a revision in 2018, one item was added to the Delivery Subscale (Item 12 [item 13 in OB form] was added. Items match the content of our theoretical framework to guide patient/family teaching which is accessible online: L., Piacentine, L., Bobay, K., & Weiss, M.E. (2018). Teaching students to teach patients: A theory-guided approach. Journal of Nursing Education and Practice, 8(11). 92-101. URL: https://doi.org/10.5430/jnep.v8n11p92
- A short form that includes the same items on the content received scale and a reduced number of items (4 items) from the delivery subscale is also available. This form has undergone limited testing with Adult Medical-Surgical patients only. Our research findings with using the QDTS indicate that the quality of ‘delivery’ of teaching is a stronger predictor of patient outcomes than the content itself. The 4 ‘delivery’ items may serve as a signal of quality of teaching ‘delivery’ but does not fully assess the 13 critical elements we have identified – see article above.
The content and delivery subscales scores are calculated separately. We no longer recommend a total score (previously the sum of content received and delivery) as these scales performed differently (they had different predictive relationships) in several studies of discharge outcomes.
Content received and delivery subscales scores are calculated as the mean of item scores (sum items and divide by number of items). We use mean of items to increase interpretability of findings. Content needed can be calculated in a similar way.
Links to English Language forms are directly below. Permission to use the scales for research or clinical practice is granted by the author (Dr. Weiss). Modification of the scales is NOT permitted. (See Permission to Use statement in the General Information section on the Hospital Discharge Scales Page. Links to approved translations are at the end of this page.
QDTS forms for adult medical surgical
QDTS long form- English
QDTS short form – English
QDTS forms for parents of hospitalized children
PedQDTS long form- English
QDTS forms for postpartum mothers
ObQDTS long form- English
Permission is granted to use the scales. No modifications are permitted. Please contact the translator to inform him/her that you plan to use. Cite Dr. Marianne Weiss as author of the scale and also cite the translator in any publications.
**Awaiting permission ##Translation/study in progress
** Awaiting permission
References to use of the QDTS – includes psychometrics
Opper, K., Beiler, J. & Weiss, M.E. (2019). Effects of implementing a health team communication redesign on hospital readmissions within 30 days. Worldviews on Evidence Based Nursing, 16(2), 121-130.
Candela. L., Piacentine, L., Bobay, K., & Weiss, M.E. (2018). Teaching students to teach patients: A theory-guided approach. Journal of Nursing Education and Practice, 8(11). 92-101. URL: https://doi.org/10.5430/jnep.v8n11p92
Weiss, M.E., Sawin, K., Gralton, K., Johnson, N., Klingbeil, C., Lerret, S.M., Malin, M., Yakusheva, O., & Schiffman, R. (2017). Discharge teaching, readiness for discharge, and post-discharge outcomes in parents of hospitalized children. Journal of Pediatric Nursing, 34, 58-64. http://dx.doi.org/10.1016/j.pedn.2016.12.019.
Lerret, S. M., Weiss, M. E., Stendahl, G., Chapman, S., Menendez, J., Williams, L., Nadler, M., Neighbors, K., Amsden, K., Cao, Y., Nugent, M., Alonso, E., & Simpson, P. (2015). Pediatric Solid Organ Transplant Recipients: Transition to Home and Chronic Illness Care. Pediatric Transplantation, 19 (1), 118-129.
Weiss, M., Yakusheva, O., & Bobay, K. (2011). Quality and cost analysis of nurse staffing, discharge preparation, and post-discharge utilization. Health Services Research, 46(5), 1473-1494. DOI: 10.1111/j.1475-6773.2011.01267.x
Lerret, S. & Weiss, M.E. (2011). How ready are they? Parents of pediatric solid organ transplant recipients and the transition from hospital to home following transplant. Pediatric Transplantation,15,606–616 DOI: 10.1111/j.1399-3046.2011.01536.x.
Bobay, K., Jerofke, T, Weiss, M., & Yakusheva, O. (2010). Age-related differences in perception of quality of discharge teaching and readiness for hospital discharge. Geriatric Nursing, 31(3), 178-187.
Weiss, M.E. & Lokken, L. (2009). Predictors and outcomes of postpartum mothers’ perceptions of readiness for discharge after birth. JOGNN, 38, 406-417.
Weiss, M., Johnson, N., Malin, S., Jerofke, T., Lang, C ., & Sherburne, E. (2008). Readiness for discharge in parents of hospitalized children. Journal of Pediatric Nursing, 23(4), 282-295.
Maloney, L.R. & Weiss, M.E. (2008). Patients’ perception of hospital discharge informational needs. Clinical Nursing Research, 17. 200-219.
Weiss, M.E., Piacentine, L.B., Lokken, L., Ancona, J., Archer, J., Gresser, S., Holmes, S.B., Toman, S., Toy, A., & Vega-Stromberg, T. (2007). Perceived readiness for hospital discharge in adult medical-surgical patients. Clinical Nurse Specialist, 21, 31-42.
Weiss, M.E. & Piacentine, L.B. (2006). Psychometric properties of the Readiness for Hospital Discharge Scale. Journal of Nursing Measurement, 14(3), 163-180.
Chen, Y., & Bai, J. (2017). Reliability and validity of the Chinese version of the Readiness for Hospital Discharge Scale-Parent Form in parents of preterm infants. International journal of nursing sciences, 4(2), 88–93. https://doi.org/10.1016/j.ijnss.2017.01.009
Malagon-Maldonado, G., Hiner, J.B., & Lanciers, M. (2015). Broadening the horizons on predictors of discharge teaching, discharge readiness, and postdischarge outcomes. JOGNN, 44 (Supplement 1), S58. https://doi.org/10.1111/1552-6909.12628
Rio L, Tenthorey C, Ramelet AS. Unplanned postdischarge healthcare utilisation, discharge readiness, and perceived quality of teaching in mothers of neonates hospitalized in a neonatal intensive care unit: A descriptive and correlational study. Aust Crit Care. 2021 Jan;34(1):9-14. doi: 10.1016/j.aucc.2020.07.001.