Being discharged from a hospital or medical center is frightening to seniors at best, so a positive discharge experience is vital to the healing process.
Hospital Discharge Transition Time – click @ morguefile.com
As more and more seniors are utilizing medical centers and hospitals, the importance of a good discharge is being noticed by both patients and their family members. Since the last thing that happens creates the most outstanding memory of the hospital, it would be wise for hospitals to give particular attention to discharge procedures.
What is Needed in a Good Hospital Discharge
A good hospital discharge may include:
Presenting the paperwork in a gentle and non-rushed manner. (This can help to allay fears the patient may have about managing their injury or condition after hospitalization.)
Specific referral information which can point toward future success in maintaining healthy living.
Clear instructions about when any prescribed medication is indicated, as well as information when to seek professional follow-up treatment.
Reassurance to help reduce the stress of transitioning to home or wherever the next placement is, without the constant input of medical staff which was available in the hospital.
Answering patient’s questions or providing someone who can give answers to the patient and their friends or family, including caregiver information when needed.
Challenges with Some Hospital Discharge Procedures
Due to rather long wait times between the decision to discharge and the patient’s actually leaving, some patients report feeling like a non-entity during that time.
Since the patient isn’t treated as an inpatient any more during the transition time, there is the danger of a disconnect occurring which leaves the patient somewhat lost in the middle of the system.
Due to medical staff overload, they may be quite busy tending to other equally deserving patients, leaving the discharge patient feeling uncomfortable and such uncertainty raises anxiety on their part and that of the family or friends.
An example could include a senior from another state who was admitted for a few days. Upon reading discharge paperwork, she asked for clarification from the obviously busy charge nurse who reminded the senior that she had four other discharges to finish. This type of occurrence may point to the need for accessible personnel to be available during discharge transition.
Possible Improvements to Hospital Discharge Methods
Just as all inpatient facilities have thorough intake procedures, giving space, personnel, and careful attention to both accuracy and completion of admission and registration services, discharge procedures might benefit from similar attention. Perhaps such attention to detail is in order for discharge policies and practices.
Since nurses and doctors are pulled from many directions, there could be personnel dedicated specifically to discharge. This could include volunteers and others.
A Discharge Kit, much like the Welcome Kit patients receive upon admission, could include a snack, lotion, a couple of goodies much like is distributed at workshops, a Thank You card from the hospital, and materials specific to the particular facility and patient as well as the discharge paperwork. This could be a plastic or paper bag, and would make leaving so much easier as the patient and family would not have to juggle stuff on their way to the car, etc.
Whatever patient contact staff is involved would benefit from a reassuring voice while sharing referral information including classes and sources of help in the community.
This kind of interaction with the patient, which may involve listening to the older adult patient and family members, would offer hope for the transition upon leaving the medical facility, as well as help allay fears and restlessness during the wait.
Imperial Point Hospital Works to Improve Discharge Process
According to Abigail Fortay, Imperial Point Hospital’s Regional Marketing Director for Broward Health in Ft. Lauderdale, Florida, the objective of discharge is to help keep patients out of the hospital. She states that a good discharge helps avoid return admissions.
Broward Health’s Regional Manager of Case Management, Linda Nesgoda, adds that the goal is to have an excellent transition from the hospital to home or wherever else the patient is headed. She says this hospital is continuously updating their discharge procedure by using a Transition Team. This team includes a case manager, nutritionist, medical staff, and even a pharmacist to explain medications to the patient when needed.
They meet once a month and start planning for discharge upon admission. There is a concerted effort to be disease specific by providing special information for different needs, e.g. stroke, cardiac health, COPD, diabetes, and so on. There is even an effort being currently made by the Customer Service Rep to enlist volunteers, especially retired nurses for exit consultation a part of the discharge. In addition, the Transition Team trains nurses and doctors to provide more customer friendly service in the area of discharge as well as in other situations.
Imperial Point Hospital also has a Speak Up Program which encourages the patient, family or friends to speak up when they see a need. They can also ask for the nurse manager or case manager. The case manager is in charge of securing materials or equipment needed at home on or before the discharge date. The patient may receive a follow up phone call the day after discharge to address any questions or concerns at that time.
Another program which feeds in to making a successful discharge is the NICHE certification (Nurses Improving Care for Health of Elders). A social worker helps maintain relationships with seniors who have been or may be patients, making hospital services more thorough in meeting their needs.
There is no doubt that a positive hospital discharge is vital to a successful hospital stay. Some key elements need to be present in a good discharge experience. There can be challenges along the way, and some improvements may be needed. Imperial Point Hospital in Fort Lauderdale has an ongoing Transition Team which works to make the patient’s hospital discharge a stress-free experience.
Source: Two separate interviews with Abigail Fortay and Linda Nesgoda on May 31, 2012.
Copyright Hildra Tague. Obtain permission for use in print or online.