scholarly journals The Role of Effective Discharge Planning in Preventing Homelessness

2007 ◽  
Vol 28 (3-4) ◽  
pp. 229-243 ◽  
Author(s):  
Thomas E. Backer ◽  
Elizabeth A. Howard ◽  
Garrett E. Moran
2020 ◽  
pp. 345-352
Author(s):  
Catherine Gaynor

‘Discharge from hospital and early supported discharge’ provides some useful guidance and outlines the issues that we encounter in facilitating effective discharge from hospital following a stroke. Hospital discharge is an important milestone in a stroke patient’s journey. It marks the end of the acute hospital episode, and the start of a new life living with and adjusting to their stroke and its sequelae. It can be a stressful time for patients and their carers, but careful and thorough discharge planning can help to ease the transition from hospital to home. The chapter explores the timing of discharge, models of care after discharge, early supported discharge, the evidence from SSNAP (Sentinel Stroke National Audit Programme) in the United Kingdom, the initiative of CLAHRC (Collaborative for Leadership in Applied Health Research and Care), guidance from the National Institute for Health and Care Excellence (NICE), institutionalization, role of capacity, role of IMCA (independent mental capacity advocate), communication with primary care, and follow-up after discharge from hospital.


2013 ◽  
pp. 103-108
Author(s):  
Chiara Bozzano ◽  
Ilario Lancini ◽  
Elena Mei ◽  
Maida Lucarini ◽  
Roberta Mastriforti ◽  
...  

Introduction: To evaluate the use of multidimensional assessment based on the Fluegelman Index (FI) to identify internal medicine patients who are likely to be difficult to discharge from the hospital. Materials and methods: Have been evaluated all patients admitted to the medical wards of the District General Hospital of Arezzo from September 1 to October 31, 2007. We collected data on age, sex, socioeconomic condition, cause of admission, comorbidity score preadmission functional status (Barthel Index), incontinence, feeding problems, length of hospitalization, condition at discharge, and type of discharge. The FI cut off for difficult discharge was > 17. Results: Of the 413 patients (mean age 80 + 11.37 years; percentage of women, 56.1%) included in the study, 109 (26.39%) had Flugelman Index > 17. These patients were significantly older than the patients with lower FIs (85 + 9.35 vs 78 + 11.58 years, p < 0.001), more likely to be admitted for pneumonia (22% vs. 4.9% of those with lower FIs; p < 0,001). They also had more comorbidity, loss of autonomy, cognitive impairment, social frailty, and nursing care needs. The subgroup with FIs>17 had significantly higher in-hospital mortality (30.28% vs 6.25%, p < 0.001), longer hospital stay (13 vs. 10 days, p < 0.05), and higher rates of discharge to nursing homes. Conclusions: Evaluation of internal medicine patients with the Flugelman Index may be helpful for identifying more critical patients likely to require longer hospitalization and to detect factors affecting the hospital stay. This information can be useful for more effective discharge planning.


2009 ◽  
Vol 21 (1) ◽  
pp. 26-31 ◽  
Author(s):  
Mary Rose Day ◽  
Geraldine McCarthy ◽  
Alice Coffey
Keyword(s):  

1984 ◽  
Vol 16 (2) ◽  
pp. 101-106
Author(s):  
Joanne V. Hickey ◽  
Janice E. McKenna

2011 ◽  
Vol 35 (3) ◽  
pp. 357 ◽  
Author(s):  
Lixin Ou ◽  
Jack Chen ◽  
Lis Young ◽  
Nancy Santiano ◽  
La-Stacey Baramy ◽  
...  

Objective. To examine the implementation of estimated date of discharge (EDD) for planned admissions and admissions via the emergency department, to assess the variance between EDD and the actual date of discharge (ADD), and to explore the determinants of delayed discharge in a tertiary referral centre, Sydney, Australia. Methods. Primary data from a convenience sample of 1958 admissions for allocation of EDDs were linked with administrative data. The window for assigning EDDs for planned admissions was 24 h, for admissions via the emergency department it was 48 h. Logistic regression models were used to examine the key factors associated with an EDD being assigned within 24 h or 48 h of an admission. An ordinal logistic regression model was used to explore the determinants of delayed discharge. Results. Only 13.4% of planned admissions and 27.5% of admissions via the emergency department were allocated a timely EDD. Older patients, patients with significant burdens of chronic morbidity (OR = 0.903; P = 0.011); and patients from a non-English-speaking background (OR = 0.711; P = 0.059) were less likely to be assigned a timely EDD. The current Charlson Index score was a significant predictor of a positive variance between EDD and ADD. Conclusions. The prevalence of the timely assignment of an EDD was low and was lowest for planned admissions. The current Charlson Index score is an effective tool for identifying patients who are more likely to experience delayed discharge. What is known about the topic? Failure to assign an EDD is one of the major barriers to implementing effective discharge. Establishing an EDD for a patient within 24 h of an admission is thought to be a measure of efficient and high quality discharge planning. What does this paper add? Older patients, patients with significant burdens of chronic morbidity, and patients from a non-English-speaking background were less likely to be assigned a timely EDD. The current Charlson Index score was a significant predictor of a positive variance between EDD and ADD. What are the implications for practitioners? A significant gap existed between policy and the implementation of assigning EDD in a large sample of discharges. Effective discharge planning may be obstructed by failure to assign an EDD at the time of admission.


2014 ◽  
Vol 5 (1) ◽  
Author(s):  
Yupi Supartini

Informasi dalam keperawatan semakin dirasakan pentingnya, baik dalam penyusunan rencana strategis, pengambilan keputusan maupun dalam menilai efektifitas dan efesiensi dari pelayanan keperawatan. Salah satu contoh manajemen informasi yang akan dikemukan adalah tentang kebutuhan anak yang dirawat dengan Bronchopneumonia pada setiap tahapan discharge planning (rencana pemulangan pasien). Tahapan yang satu meyediakan informasi penting, dan sangat menetukkan pada tahapan selanjutnya. Semua data yang didapatkan pada fase akut yang dilaksanakan di klinik anak dan atau di ruang gawat darurat, diproses oleh tim kesehatan dengan menggunakan pengetahuan dasar dan membandingkannya (comparing system) dengan data dasar keperawatan dan pengetahauan kedokteran, fisiologi, patofisiolohi, sosiologi, psikologi, dan farmakolohi. Dengan demikian akan didapat informasi tentang masalah anak tersebut dan kebutuhan pada fase berikutnya yaitu fase transisi yang dijalankan di ruang rawat. Demikian pula proses manajemen informasi dari fase transisi yang dilakukan di ruang rawat akan sangat menentukan langka selanjutnya yaitu perawatan lanjutan di rumah/di masyarakat. Mengingat kegiatan penyusunan rencana pemulangan pasien pada anak yang dirawat dengan BP melibatkan tim multidisiplin, maka penting adanya seorang coordinator yang dapat mengatur kegiatan dari setiap anggota tim, sehingga tujuan dari rencana pemulangan pasien dapat dicapai dengan optimal. Perawat adalah orang yang paling tepat sebagai coordinator penyusunan rencana pemulangan pasien, karena berada di dekta pasien selama 24 jam, memahami segala kebutuhan pasien dengan baik, dan memungkinkan untuk dapat memfasilitasi peran dari setiap anggota tim untuk mengelola informasi rencana pemulangan pasien bagian anak yang dirawat dengan BP. It has been discussed that information in nursing becomes important in making a strategic planning. Decision making or evaluating the affectivity an the efficiency of the nursing service. One of the example of Information Management that would be describe is the children’s need who are hospitalized with Bronchopneumonia in every step of Discharge Planning. Each step provides the essential information, which could determine the next step. All the data which have been gained in the acute phase at the out patient department and/ or at the emergency department are processed by using the knowledge base, compare it with the data base of nursing, medical knowledge, physiology, patophysiology, sociology, psychology and pharmacology. As the outcome from this process, the information about the child’s problems and their needs in the transitional step will be gained. It is also occur on the management information at the transitional step in the ward, it will determine the following step as the preparation for discharge planning. Discharge Planning for the child to have a coordinator, because he/she is in the ward 24 hours and understand the patients’ condition and their needs well. He/she also could facilitate the role of each member of Discharge Planning team, to manage the information about Discharge Planning for a child with Broncho Pneumonia.


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