8 best practices for discharge planning

A recent article in the Journal of Nursing Administration  highlights hospital initiatives designed to streamline the discharge process and improve outcomes for patient transitions from hospital to home and community-based care. Implementation of these programs has varied as hospitals have customized discharge care into innovative roles and functions. In order to maximize effectiveness, nurses must work with other members of the care team to ensure that all aspects of a comprehensive hospital discharge strategy are applied.

Improving the discharge process and reducing hospital readmissions are priority issues in the national agenda for healthcare reform, both in terms of the quality and cost of healthcare.

Discharge goals

Recent research has shown that top 8 patient discharge objectives are as follows:

1. Have their follow-up and home care arranged
2. Know when they will be going home and what they have to do on the day of discharge
3. To feel safe, that is, to feel like they are ready to go home (or transition elsewhere)
4. Have the information needed for going home and caring for themselves in the days after discharge
5. A convenient, fast, and pain-free transition from hospital to home
6. Ensure that all their questions are answered, their feelings considered, their families involved
7. Flexibility in the process to adjust to their individual needs
8. Continuous, ongoing healing relationship with the care providers.

To achieve this, there must be effective interprofessional communication between nurses, doctors, and any other caregivers that interact with patients and their family members.

The reality

Despite the value of these goals, many patients don't receive the help they want and need.

In addition to general informational needs, clinically related educational needs are also often not properly addressed. A survey revealed that more than 50% of patients with a stay of 5 days or less failed to receive information on side effects, recovery at home, or community health services.  Another study found that 81% of patients needing assistance with basic functional needs failed to receive home care referrals.

Nurses must do a better job of anticipating patients’ needs at discharge, and providing the right quality and quantity of education and information.

What's working

Discharge preparation includes discharge planning, discharge coordination, and discharge teaching, which are all centered around the RN. In cases where patients are coming in for a scheduled procedure, preadmission education has been shown to be very successful. Nurses can phone patients and send educational literature and/or videos related to their procedure. For example, if a patient is coming in for a knee replacement, he or she can even come to the hospital in advance for an information session. Start early with preadmission or preoperative education, and patients will feel more at ease right from the get go.

For more information on how Lippincott Solutions can help optimize patient discharges, check out Lippincott Advisor which features over 12,000 evidence-based monographs and patient-teaching handouts, and now includes the brand new, expanded Patient Teaching Navigator functionality.

The new Patient Teaching Navigator component of Lippincott Advisor will help educate your staff on exactly what to say to patients, and how to assess and identify those who may present challenges to customary patient teaching strategies.

Does your facility have written discharge policies and procedures? What have you found to work best?  Leave us a comment below.