When are patients ready to go home from the hospital? A Marquette researcher’s scale tells you.

When asked to quantify the impact her readiness for hospital discharge scales have had on the nursing profession, Dr. Marianne Weiss, professor emerita, confessed that she has a problem keeping track.

"We don't collect data on how many people are using them because, frankly, it just got overwhelming," Weiss says.

What Weiss does know is that her scales, meant to give nurses a means of evaluating whether patients are ready to be discharged from the hospital, have been translated into more than two dozen languages, with more on the way. Every day, she gets emails from nurse researchers and Doctor of Nursing Practice students around the world asking if they can use the scales in their own studies. They've earned Weiss a spot among the top 2% of most cited researchers in the world, per Stanford University.

It all started during Weiss' career as a research nurse in obstetrics in California, where the length of hospital stays for patients began declining rapidly as health care advanced. Weiss became interested in the experiences of new mothers who were going home from the hospital after only one to two days.

"I quickly realized that we didn't have the instruments available to measure what we wanted to measure," Weiss says. "So, we had to go through the process of developing new instruments."

After moving to Wisconsin to teach at Marquette, Weiss began the process. She and her research team collected data on more than 400 patients to determine what questions were most important in determining whether a patient felt ready for discharge. They settled on several key questions:

• How ready is the person feeling physically and emotionally about going home from the hospital?
• How much does the person know about self-care at home after discharge?
• How will the person cope with the demands of personal and medical care needs at home?
• How much support will the person have at home, if needed, after discharge?

Dr. Stacee Lerret, Grad '02 (MSN), Grad '11 (Ph.D.) collaborated with Weiss to develop the scales. She also uses them in her own research, as well as NIH-funded studies, with the pediatric transplant population. To Lerret, the scales are a necessity.

"I frequently saw families who were eager to go home from the hospital but still felt overwhelmed, even after receiving discharge education," Lerret says. "We needed a way to better understand what support families still needed once at home and why some were returning to the hospital for challenges that might have been preventable."

"I now have lots of doctoral students who once worked with me who are now faculty members at Marquette, and I love connecting with them."

Once the scales were published, the research team did a follow-up survey with 33 hospitals and approximately 70,000 patients to determine whether the scales were useful. The overwhelming answer: "yes." Nurses reported completing each interview in relatively little time and using the scale showed positive impact on readmission rates.

"Hospitals don't get paid very well, if at all, for readmissions because they were supposed to prevent those issues in the first place," Weiss adds. "It impacts the bottom line if patients are coming back too often, so anything that can help health care professionals identify potential problems during discharge is going to be important."

Both Weiss and Lerret agree that the scales raise as many questions as they answer. Integration with medical records and artificial intelligence applications may very well be the next frontier, allowing nurses to make even greater use of these tools.

It's an exciting prospect for Weiss, who carries on extensive research activity well after retiring from Marquette.

"I now have lots of doctoral students who once worked with me who are now faculty members at Marquette, and I love connecting with them," Weiss says.

Lerret continues to engage in regular scholarly meetings with Weiss, demonstrating the lasting impact of intentional mentorship in academic nursing. Her work with Weiss on the discharge scales showed her what research mentorship looks like: patient guidance, meaningful encouragement and an unwavering commitment to helping mentees exceed their own expectations.

"I have worked alongside and been mentored by Marianne my entire research career, and we've been able to learn from each other the whole time, which is the sign of an incredible relationship," Lerret says.

A college culture of trust and collaboration among researchers created an environment that supported Weiss' research team as they developed and tested the scales. As a result, these scales are in use worldwide, and Weiss remains excited to see what comes next.

"I just love research," Weiss says.