Expect an Excellent Discharge Experience

Posted: Tue, Sep 16, 2014 15:05

When you do discharge correctly, you have fewer patients return for readmission.

Let’s take a look at the penalties: hospitals in the bottom quartile from the previous year will have a percentage of their Medicare payments withheld. In FY 2013, it’s up to 1% - and there are 2200 hospitals at risk! By FY 2015, it’s going to be 3% of your DRGs.

Is your hospital going to be among those at risk? Can you afford to ignore this domain? Because *spoiler alert*: discharge does not begin and end at the hospital. Discharge starts when your patient arrives and ends when he/she is healthy, not when he/she leaves the facility.

Consider This:

1. Invent a Mission Statement.

Why not create your own team (or unit) based mission statement based on your team’s shared goals and values? Good examples of a team mission statement are:

• We are going to provide a safe discharge every time
• No adverse events
• Excellence in recovery at home, or
• We empower self-reliance in every patient

The concept of the mission statement is just to have clarity about what you want to accomplish during this process.

2. Create Expectations in the Hospital.

Discharge starts at admitting! I believe that “discharge information” is not something heaped on a patient at the end of a stay, it’s an ongoing process. A great Admitting staff informs the patient that a well-planned discharge is a hospital priority. “We’ll start preparing and educating you long before we’ll say goodbye.” Engage active participation from patients and family members as partners with a friendly conversation. You want to document the patient’s functional status: what’s the risk at home? Introduce the Discharge Co-ordinator to create anticipation. “Gladys and June are going to be looking after you. They are wonderful nurses, I know they’ll make this a good experience for you.”

3. Ensure Adequate Support at Home.

Make sure that your patient has adequate support at home, whether it’s family, friends, or professional caregivers. If family members are assuming caregiving responsibilities, ensure that they receive pertinent information regarding home care, pain management, medications, etc.

Part of a successful discharge process is setting expectations for patient care in the hospital and patient care at home. Have a mission statement that explains what your discharge goals are. Make sure that patients are aware of their new health realities. They may not be able to get around like they used to, so they may need to make different lifestyle decisions. Remind the patient that he or she will no longer have everything done for them. A certain degree of independence is required for a healthy recovery at home.

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