Surveying the Effect of Clinical Audit Process on Discharge against Medical Advice from Hospital Emergency Ward in Tabriz, Iran

Background & objectives: Discharge against medical advice (DAMA) is one of the problems that health systems are involved in. Patients who leave hospital against medical advice may be at risk of adverse health outcomes and readmission. The aim of this study was to determine the causes of discharge with personal consent and to perform appropriate interventions to reduce it in the hospital under study. Methods: This study was a pre- and post-interventional study. First, the data extracted from the discharge sheets were analyzed with personal consent in the hospital safety office, then interventions were designed to reduce the self-discharge rate with personal consent and the results were compared with the results with pre-intervention outcomes. Results: The rate of DAMA before the intervention was 10% which decreased to 8% after the intervention. The most important reasons for discharge against medical advice were family obstacle, lack of satisfaction to be inpatient and feeling of recovery. Conclusion: Based on the results of the present study, the majority of discharges AMA were due to patient-related issues. Increasing patients' awareness of the possible side effects of discharge with personal consent, planning an outpatient treatment program, timely assignment of the patient and establishing effective communication can be helpful in reducing the discharge AMA cases.