Discharge Program Improvement: A Case Study

The overall process of discharging a patient from a hospital and the transition back home or to a care facility are critical advancements in the overall course of both acute and long-term care. It is important that the hospitals releasing these patients have ensured the proper overall course of care from beginning to end. The lack of consistency with both the discharge process and the quality of discharge planning has led to many avoidable readmissions. To reduce the amount of hospital readmissions, it is imperative that hospitals recognize the need for focused patient care and that programs are being implemented to assist in the care transition.

However, that is not always possible because their in-network hospital may not have a bed available. I have to make sure that all the outpatient providers are in-network with the insurance as well otherwise it will not be covered by the insurance and the patient will not be able to afford the cost of care. I thought having a hospitalist and working closely with the Kaiser case manager to address discharge planning needs helped maintain care quality and contain the cost of care. Successful discharge planning that reduces readmissions are high priority issues addressed in the healthcare reform agenda because it affects both quality and cost of care (Weiss et al., 2015). Weiss et al. (2015) also stated that "...hospitalized patients, regardless of risk status or the setting to which they are being discharged, require some

Ineffective discharge teaching often leads to unnecessary admissions to the hospital resulting in negative patient outcomes and decreased patient satisfaction. This negatively impacts the well-being of the patient and creates a financial burden on institutions. As a result, this universal practice issue requires a call to action on the part of the nursing profession. Nurses can proactively assist in assuring incidents of readmission do not occur. Nurses as educators play a critical role in the successful transition of patients from hospital to home. The overall goal of discharge education is to ensure there is an exchange of critical information between the patient and nurse in which plans of care are understood and followed. The research

Internal method will be the interdisciplinary team such as hospitalist, therapists, dietician, pharmacist, case managers, discharge planners and house supervisors. These stakeholders performed a thorough discussions about patient’s admission, transfer, and discharges. Upon discussing with the patient’s overall health concerns, the evidence-based practices of bedside reporting can be part of the daily discussions because this is where the basis of patient’s health outcomes can be obtained. The goal of bedside reporting is to promote safety and highest quality of care. Therefore, the input and opinions of the whole team is very essential for the successful implementation of the bedside reporting. The bedside reporting will be more stronger tools

What does your state law say regarding public hospitals and discharging patients who do not have a place to go?

The main role of the position is to provide clients with resources to have a safe and successful discharge. The essential duties of a discharge planner is to meet with an interdisciplinary team each morning to discuss the long length of stays, which clients will be discharging that day and whether home is a safe option. Some challenges discharge planners face that correlate with social issues are, clients

The descriptive statistics were used to evaluate the occurrence of rehospitalization within 30 days (readmission return to emergency department) and discharge outcomes (length of the stay and discharge time). Table 2 on page 252 presents the number and percentage of patients readmitted within 30 days from both groups; this descriptive statistic is also presented in the Figure on page 252. The mean length of stay and standard deviation are included in the same table. In addition, the inferential statistics, such as the t test, the Chi square (2), and logistic regression (odds ratio) were used. The t test was used to analyze interval or ratio data, for example: the length of stay or time of discharge. The Chi square (2) test was used to analyze nominal/categorical data, for example: to assess the relationship between the readmission to the hospital (or ER) and the type of medical team the patient had (with or without the NP). The authors considered a p value below 0.05 as a significant. In addition, the odds ratio was calculated using the logistic regression to

The clinical problem with this case scenario bring up one of many common concerns. Many hospitals today plan discharge for patients as soon as they are admitted. There are many concerns that come from this fast assumption of discharge. Planning for discharge before the patient is fully assessed by the nurse also involves fast discharge teaching, which leaves the patient and caregivers anxious and uneducated about their future. This is where the problems come into play with the nurses, patients, and caregivers. When it comes to this scenario, caregivers are scared or hesitant to have to care for loved ones on such short notice and after a brief hospital stay. This normally

After discharge from the GEM unit, 39 (83.0%) of patients returned home, 1 (2.3%) returned to residential care, 2 (4.7%) went to a hospice, 3 (6.4%) went to another rehabilitation hospital, and 2 (4.3%) returned to acute care. After discharge, 26.1% of patients had a single readmission within 3 months, 10.9% of patients required multiple (≥2) readmissions and 66.0% patients had died (n=28) at the time of follow-up (roughly 1-2 years post discharge). (Table 2).

As a Case Manager working in a hospital environment, getting patients moved through the continuum of care is high on the list. Discharge planning (DP) is crucial for a smooth transition. It starts on the day of admission when the Case Manager sees the patient/family for the first time to do an admission assessment. Discharge planning continues throughout the patient stay. The Case Manager attends round with the Doctor, Nurse Practitioner, and Pharmacist to discuss the plan of care for the patient with an anticipated discharge date. The Case Manager collaborates with the team to anticipate the needs of the patient and set the DP in motion.

He could not feel his finger. There is numbness. The symptoms are continuous in nature and currently present. He also reports paresthesias. There were no chemical or toxic compounds involved. The findings were consistent with the injury. There were no conditions that may impede or delay the recovery. The exam revealed circumscribed laceration around the PIP joint of the middle finger. ROM: the finger is pale and cool without restriction. Neurologically: no sensation in his right middle finger. Plan: OR for revascularization, possible operative fixation, possible revision amputation, possible nerve graft, and possible vein

On September 16, 2016 at approximately 00:44 hours, East Officer Ariel Weiland (419) along with fellow Officer Omar Alonso (420) and Security Supervisor Steven Evans (407) responded to a (51S) Patient Stand by in E.D. room #24. Upon arrival Register Nurse Corrine Caswell stated, patient Anthony Stafford (DOB/FIN: 02/16/1966; #86183714) had been medically cleared and was about to be discharge but prior to being discharge, he requested Narcotics to be administered before he leave. Nurse Caswell informed him that she was not able to fulfill his request. Mr. Stafford then began complaining and requested to speak to a Charge Nurse in order to submit a formal complaint. At 0100 hours E.D. Charge Nurse Luke Monterola arrived and spoke to the patient

readiness. The method of educating the nurses should be selected based on evidence demonstrating that it is effective. Workshops have been shown as an effective teaching method to support staff nurse education (Galarza-Winton, Dicky, O’Leary, Lee, O’Brien, 2013; Lamiani & Furey, 2009). The reviewed studies demonstrate the influence education can have on nurses who do not fully understand the ramifications of an inadequate discharge process. Teaching nurses to be better patient educators and support a successful discharge process is an important component in improving the parental perception of discharge readiness. In a study by Weis, Piacentine, Lokken, Ancona, and Archer (2007) a correlation between higher quality of discharge teaching

Rationale: Anticipating possible obstacles that may be present at the time of patient discharge, may prevent the anxiety/fear felt by patients at the time of discharge, and avoid the feeling of not being prepare to be discharge. Assessing potential barriers, such as lack or limited family support, home care support and even transportation to continue with follow up visits would aim towards discharge preparedness. In addition, active participation during the discharge planning process, would also prepare for discharge, make informed decisions about transitional care.

Using the seven key principles of the hospital discharge process devised by the Department of Health (DH, 2003), this case study will critically analyse the process of an elderly patient who was discharged from a local acute trust. It begins by providing a definition of discharge planning, before providing a brief biography of the patient, including a rationale of why this patient was selected, details of her past medical history, reason for current admission, any issues raised and details of any care provided. Throughout this case study, in accordance with the Nursing and Midwifery Council (NMC, 2008) and the Data Protection Act (1998), the patient shall be referred to as Mrs. Blue to maintain anonymity. Although the