{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T07:02:06Z","timestamp":1785308526691,"version":"3.55.0"},"reference-count":38,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T00:00:00Z","timestamp":1785110400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T00:00:00Z","timestamp":1785110400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100003579","name":"University of Toronto","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003579","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009271","name":"Canadian Nurses Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009271","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005109","name":"Registered Nurses\u2019 Foundation of Ontario","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005109","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Clinical Nursing"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To achieve expert consensus on quality indicators for evaluating discharge planning processes in inpatient mental healthcare settings. This study is part of a larger multiphase project to develop an instrument to measure and evaluate the quality of discharge planning in mental healthcare.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A modified two\u2010round Delphi study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A province\u2010wide multidisciplinary expert panel comprising nurses, social workers, occupational therapists and psychiatrists across Ontario, Canada completed two online survey rounds. Panel members assessed 79 preliminary indicators identified from a prior concept analysis and focus groups, rated the importance of each indicator and provided narrative feedback to support indicator refinement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In Round 1, 37 panellists evaluated 79 quality indicators. Seventy\u2010four indicators achieved the predefined consensus threshold; however, further review of panel feedback resulted in the removal, consolidation and refinement of indicators due to conceptual overlap, redundancy, or feasibility concerns. Thus, fifty\u2010three indicators were retained following Round 1. In Round 2, 36 panellists reviewed the revised indicator set and evaluated three new candidate indicators. Two additional indicators achieved consensus and one indicator was reinstated, resulting in a final set of 56 indicators across seven domains: Comprehensive Needs Assessment (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200914), Information Gathering and Synthesis (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20093), Patient Capacity Assessment (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20094), Collaborative, Patient\u2010Centred Care (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200914), Resource Availability Management (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20095), Care and Service Coordination (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20097) and Discharge Plan (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20099).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A multidisciplinary expert panel reached consensus on 56 quality indicators evaluating discharge planning processes in inpatient mental healthcare settings. The findings provide an evidence\u2010informed foundation for future development and testing of measurement approaches to evaluate discharge planning quality in mental healthcare.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Implications for the Profession and Patient Care<\/jats:title>\n                    <jats:p>The discharge planning domains and quality indicators identified in this study may support future efforts to evaluate discharge planning processes, identify gaps in care and inform quality improvement initiatives aimed at supporting continuity of care and transitions from hospital to community settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Impact<\/jats:title>\n                    <jats:p>This study addresses the lack of standardized quality indicators for evaluating discharge planning processes in inpatient mental healthcare settings. Through a two\u2010round Delphi process, a multidisciplinary expert panel reached consensus on 56 indicators reflecting core components of discharge planning, including comprehensive needs assessment, patient capacity evaluation, coordination of community services and supports, housing\u2010related planning\u00a0and follow\u2010up care. The study findings provide a foundation for future development and psychometric evaluation of a standardized measurement instrument to assess discharge planning quality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Reporting Method<\/jats:title>\n                    <jats:p>This study is reported in accordance with the Guidance on Conducting and Reporting Delphi Studies (CREDES) recommendations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patient or Public Contribution<\/jats:title>\n                    <jats:p>No patient or public contribution.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jocn.70466","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T09:07:15Z","timestamp":1785143235000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Quality Indicators to Evaluate Discharge Planning Processes in Mental Healthcare Settings: A Modified Delphi Survey of a Multidisciplinary Expert Panel"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1064-1958","authenticated-orcid":false,"given":"Sarah","family":"Xiao","sequence":"first","affiliation":[{"name":"Lawrence Bloomberg Faculty of Nursing University of Toronto  Toronto Ontario Canada"},{"name":"The Nethersole School of Nursing, Faculty of Medicine The Chinese University of Hong Kong  Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann","family":"Tourangeau","sequence":"additional","affiliation":[{"name":"Lawrence Bloomberg Faculty of Nursing University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8132-061X","authenticated-orcid":false,"given":"Kimberley","family":"Widger","sequence":"additional","affiliation":[{"name":"Lawrence Bloomberg Faculty of Nursing University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Whitney","family":"Berta","sequence":"additional","affiliation":[{"name":"Institute of Health Policy, Management and Evaluation University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,27]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10935-007-0095-7"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0020476"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/qhc.11.4.358"},{"key":"e_1_2_12_5_1","unstructured":"Canadian Institute for Health Information.2013.\u201cHealth Indicators.\u201dhttps:\/\/secure.cihi.ca\/free_products\/HI2013_Jan30_EN.pdf."},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1176\/ps.48.4.518"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2019.03.011"},{"key":"e_1_2_12_8_1","volume-title":"Transfer of Care and Shared Care: Chief Psychiatrist's Guideline","author":"Department of Health, State of Victoria","year":"2023"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2013.12.002"},{"issue":"1","key":"e_1_2_12_10_1","first-page":"1","article-title":"A Historical Perspective of Treatment and Discharge Planning for the Seriously, Chronically, Mentally Ill Patient: A Review of the Literature","volume":"2","author":"Dlabal S.","year":"2017","journal-title":"Journal of Advanced Practice Nursing"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.260.12.1743"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2753.2000.00269.x"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2850.2008.01266.x"},{"issue":"4","key":"e_1_2_12_14_1","first-page":"S706","article-title":"Discharge Planning and Mental Healthcare Act 2017","volume":"61","author":"Gowda M.","year":"2019","journal-title":"Indian Journal of Psychiatry"},{"key":"e_1_2_12_15_1","volume-title":"The Practice of Nursing Research: Appraisal, Synthesis, and Generation of Evidence","author":"Grove S. 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