Discharge Rounding: A Case Study

Improving the quality of discharge planning in acute care include addressing the lack of appropriate staff and patient education about appropriate planning for discharge (4). This includes implementing proper discharge teaching regarding signs and symptoms to seek medical attention, management and care of medical equipment, and access to community resources (4, 5). Other challenges are patients with complex comorbidities too difficult to discharge as well as lack of community supports and equipment for newly discharge patients and lack of rehabilitation and nursing home beds (4). Consequently, acute care units are pressured to vacate hospital beds in response to the growing elderly population. Hospital professionals tend to focus discharge teaching and preparation on medical areas such as diet, activity, treatments, and medications (5). Community referrals to appropriate services at the time of hospital discharge does not often happen contributing to poorer patient outcomes and re-hospitalizations

Traditionally, nursing shift-to-shift reports were organized methods of communication between only the oncoming and leaving nurse, designated to a location such as the central nursing station or nook of a hallway. Shift reports can be considered the foundation of how the day is going to plan out because it introduces the patient, diagnoses, complications, medications, consults, upcoming test and the entire plan of care. These reports are full of complicated and vital information and while set in certain locations that are vulnerable to interruptions, such as the nursing station, medical errors and miscommunication are more likely to be made. The Joint Commission’s 2009 and 2010 National Patient Safety Goals (Joint Commission, 2015) included two patient safety standards, first to encourage patients to be involved in their health care plan and second, to implement a standardized communication process for handoff reports between providers. Soon after in 2013, The Agency for Healthcare Research and Quality under the United States Department of Health and Human Services introduced a set of strategies to improve patient engagement along with safety and quality in patient care. Within these strategies the new method of nurse bedside shift report was developed, which suggests nurses to conduct shift-to-shift reports at bedside in the room of each patient, rather than out of the room. The benefits of this new method were

This study evaluated if changing the process of shift handover from traditional form conducted in an off stage area to handover at the bedside could lead to improved safety for patients and cost reductions by shortening the duration of handover. The researchers also examined staff perceptions and satisfaction with the traditional method of handover versus th

The hourly rounding log is designed in accordance with the hospital’s policies and procedures. A clinical committee is consulted in designing the documentation log to suit the needs of the patients and the staff. It is composed of four columns. The first column is the time period, the second is the actual time that the staff rounded the patient, the third is the staff’s initials who make the rounds, and the last one is for comments (any significant patient needs that were addressed or that patient is asleep).

Discharge planning is a routine feature of health in many countries. The aim of discharge planning is to reduce hospital length of stay and unplanned readmissions to hospital, to improve the co-ordination of services following discharge from hospital thereby bridging the gap between the hospital and community (S. Shapperd, 2008). The focus of this story is discharge planning that occurs while

PO is referred to continue chemical dependence treatment at the community agency. PO will need to have a new assessment to determine appropriate level of care. PO is recommended to attend minimally of two self-help meetings per week, abstain from all mood-altering substance, and utilize positive support structure to aim and maintain substance free lifestyle.

CM spoke with Mr. Antunez regarding Devin transiting out of CMO. CM and Mr. Antunez discussed Devin’s growth throughout the year. CM explained to Mr. Antunez that Ms. Feliciano will link Devin to outpatient at Hoboken Medical Center or Jersey City Medical Center. CM stated that CM supervisor will also attend next month discharge meeting/ IEP meeting on October 7, 2016. Mr. Antunez agreed to Devin’s

Communication of information between health care providers is a fundamental component of patient care. The information shared during the shift exchange helps to plan patient care, identifies safety concerns and facilitates

Post-discharge follow-up visit remains a critical factor in ensuring that patients continue to do well after they leave the hospital. The success of the team was measured based on data collected after 6 months of revamping the discharge clinic and implementing a phone call system to patients. They had been given a choice of a phone call for discharge follow up or to come in within 7-14 days and be evaluated post discharge.

Other options of improving nursing shift reports would be to institute a written report to go along with a verbal report that can be passed down from shift to shift. As stated in the article the design of the handoff is just as important as how you give it. Institutions should have a form that is universal and teach all nurses how and why we use bedside shift report. Conclusion

The process of conveying information regarding a patient’s condition from one health care provider to another is referred to as a “handoff”. The primary objective of a handoff is to communicate accurate information about a patient’s health status. Currently, at the White City VA Southern Oregon Rehabilitation Center and Clinic (SORCC), there is a lack of consistency in the documentation and verbal handoff reporting between the Registered Nurse and Provider during a patient triage visit. It is imperative to improve this process in order to have effective communication between the nurse and provider, as well as provide personalized and appropriate care for the Veterans we serve.

Line 7: Key in the insured's address and telephone number, if the address is the same as the patient’s enter SAME. Complete this item only when items 4 and 11 have been completed.

Discharge planning is a process that begins upon a patient’s admission to hospital. It is not a single event that occurs upon discharge and must be planned for as early as possible to enable patient’s and their carers to be involved in their discharge plan. Discharge planning takes time but if managed well, can ensure that the patient integrates appropriately back into the community. Discharge planning should be started within twenty-four hours of admission to hospital, or during pre-admission for elective procedures. Patients require information about their condition, what to expect when they go home and when to seek help. Most patients are discharged home with new medications and instructions must be given verbally and written down for the

In evaluating possible approaches to make the discharge process clear, easy and convenient for the patient and the staff, I looked into other

Clinical staff contributed to restrictive patient flow second to subjective treatment routines and subjective diagnostic and discharge patterns. Subjective diagnostic patterns created different workflow demands on Microbiology, Radiology, and Respiratory departments. Because each patient was subjected to different diagnosis, based upon subjective assessments by clinical staff, different patient flow patterns emerged. Simultaneously each shift of clinicians had a varying diagnostic wait time, treatment time, and time to discharge. Thus, the effectiveness and experience of clinical staff is directly related to their speed and accuracy of assessment, treatment, and discharge routines.