Readiness for Hospital Discharge Scale (RHDS)
The READINESS FOR HOSPITAL DISCHARGE SCALE (RHDS) measures patient readiness to return home from the hospital following acute care hospitalization. It is administered on the day of discharge, normally within 4 hours prior to discharge.
There are forms of the RHDS for three patient populations: adult medical-surgical patients, parents of hospitalized children, postpartum mothers.
The RHDS forms are available as patient self-report tools that are completed by the patient and as nurse assessment tools to be completed by the discharging nurse. Long forms of the scales range from 21-29 items. The short forms contain 8 items. (A physician form, similar to the RN assessment form is also available for adult medical-surgical patients).
The RHDS measures 4 domains of discharge readiness: Personal status ( how the patient feels on the day of discharge); Knowledge (the patients knowledge about care of self at home after discharge); Perceived Coping Ability (how the patient will be able to cope at home after discharge); Expected Support (how much help the patient will have if/when needed at home after discharge. The short forms were created by selecting the 2 items from each subscale with the highest item-to subscale adjusted correlations.
Patient self-report scores on the RHDS are moderately correlated with quality of discharge teaching and are associated with post-discharge coping difficulty and readmission/ED use post-discharge. Nurse assessment of discharge readiness using the RHDS is a stronger predictor of readmission than patient self-report. Validity is supported by factor analysis and predictive validity with post-discharge coping difficulty and post-discharge utilization.
RHDS Scoring information: Scores are calculated by adding item scores and dividing by the number of items, thus calculating the RHDS score as the mean of item scores. The possible range of scores is 0 to 10 using this method. This approach applies to total scale and subscale scores.
There are slight differences in items between scales for different populations. Patient and nurse forms are parallel forms with the same items worded for the respondent. Use the same scoring method for patient and nurse forms.
- PT-RHDS (Adult Medical-Surgical patient): 21 items in 4 subscales:
- Personal status = items 1 to 6 (6 items); (item 2 should be reverse scored)
- Knowledge = 7 to 14 (8 items)
- Coping Ability = 15 to 17 (3 items)
- Expected Support = 18 to 21 (4 items)
- PT-RHDS (Adult Medical Surgical patient) short form: 8 items (2 per subscale above)
- RN-RHDS long and short forms are the nurse version
- MD-RHDS is the short form physician version of the PT-RHDS for Adult medical surgical patients.
- FamRHDS (for Family Caregivers of Adult medical Surgical patients) – 21 items in 4 subscales – see RHDS for Adult Medical Surgical Patients for items by subscale.
- PedRHDS (Parents of Hospitalized Children): 29 items in 5 subscales:
- Parent Personal status = 1a,2a,3a,4a,5a,6a, 6b,7a (8 items); (items 2a, 5a, 6b should be reverse scored)
- Child Personal status = 1b,2b,3b,4b,7b (5 items): (item 2b should be reverse scored)
- Knowledge = 8 to 16 (9 items)
- Coping Ability = 17-19 (3 items)
- Expected Support = 20-23 (4 items)
- PedRHDS (Parents of Hospitalized Children) short form: 8 items (1 item from Personal Status subscales and 2 items from the other subscales)
- PedRN-RHDS long and short forms are the nurse versions of the Ped-RHDS for parents of hospitalized children.
- ObRHDS (Postpartum Mothers): 22 items in 4 subscales:
- Personal status = 1-8 (8 items); (item 2 and 5 should be reverse scored)
- Knowledge = 9 to 15 (7 items)
- Coping Ability = 17-19 (3 items)
- Expected Support = 20-23 (4 items)
- ObRHDS (Postpartum Mothers) short form: 8 items (2 items per subscale)
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 provided – please contact the translator for permission to use the translation.
RHDS forms for adult medical surgical
PT-RHDS long form - English (Patient self-report)
PT-RHDS short form – English (Patient self-report)
FAM-RHDS long form- English (Family Caregiver of Adult Patient)
RN-RHDS long form – English (Nurse assessment)
RN-RHDS short form – English (Nurse assessment)
MD-RHDS short form – English (Physician assessment)
PedRHDS forms for parents of hospitalized children (including NICU)
PedRHDS long form - English (Patient self-report)
PedRHDS short form – English (Patient self-report)
PedRN-RHDS long form – English (Nurse assessment)
PedRN-RHDS short form – English (Nurse assessment)
ObRHDS forms for postpartum mothers
ObRHDS long form - English (Patient self-report)
ObRHDS short form – English (Patient self-report)
ObRN-RHDS long form – English (Nurse assessment)
ObRN-RHDS short form – English (Nurse assessment)
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.
Some scales have different items numbers depending on which revision of the English version was used for the translation. Note that in some of the translated RHDS forms, there is a dichotomous yes/no item “Are you ready to go home today?” as the first item. This item is not calculated in the scale score. If the dichotomous item is present, item numbers listed in the subscale scores above will shift +1.
** Awaiting permission ##Translation/study in progress
References related to instrument development:
Weiss, M.E. & Piacentine, L.B. (2006). Psychometric properties of the Readiness for Hospital Discharge Scale. Journal of Nursing Measurement, 14(3), 163-180.
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., 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.
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.E., Yakusheva, O, & Bobay, K.L. (2010). Nurse and patient perceptions of discharge readiness in relation to post-discharge utilization. Medical Care, 48(5), 482- 486.
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
Weiss, M.E., Costa, L., Yakusheva, O., & Bobay. K. (2014). Validation of patient and nurse short forms of the Readiness for Hospital Discharge Scale and their relationship to return to the hospital. Health Services Research, 49(1), 304-317. DOI:10.1111/1475-6773.12092.
Mabire, C., Coffey, A., & Weiss, M. (2015). Readiness for Hospital Discharge Scale for Older People: development and psychometric testing from three countries. Journal of Advanced Nursing, 71(11), 2686–2696.
Bobay, K.L., Weiss, M.E., Oswald, D., & Yakusheva, O. (2018). Validation of the Registered Nurse Readiness for Hospital Discharge Scale (RN-RHDS). Nursing Research, 67(4), 305-313. DOI: 10.1097/NNR.0000000000000293.