Effective Discharge Planning

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.

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Discharge from hospital and early supported discharge

Stroke in the Older Person ◽

10.1093/med/9780198747499.003.0022 ◽

2020 ◽

pp. 345-352

Author(s):

Catherine Gaynor

Keyword(s):

Discharge Planning ◽

Models Of Care ◽

Effective Discharge ◽

The United Kingdom ◽

Early Supported Discharge ◽

Hospital To Home ◽

Discharge From Hospital ◽

Applied Health Research

‘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.

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Characteristics of Effective Discharge Planning Programs for the Frail Elderly

Journal of Gerontological Nursing ◽

10.3928/0098-9134-19910701-05 ◽

1991 ◽

Vol 17 (7) ◽

pp. 10-14 ◽

Cited By ~ 17

Author(s):

K Sue Haddock

Keyword(s):

Frail Elderly ◽

Discharge Planning ◽

Effective Discharge

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Effective Discharge Planning And The Neurosurgical Nurse

Journal of Neuroscience Nursing ◽

10.1097/01376517-198404000-00008 ◽

1984 ◽

Vol 16 (2) ◽

pp. 101-106

Author(s):

Joanne V. Hickey ◽

Janice E. McKenna

Keyword(s):

Discharge Planning ◽

Effective Discharge

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The role of the hospital liaison nurse in effective discharge planning for older people: perspectives of discharge planners

Contemporary Nurse ◽

10.5172/conu.1999.8.3.99 ◽

1999 ◽

Vol 8 (3) ◽

pp. 99-106 ◽

Cited By ~ 8

Author(s):

Anne Hofmeyer ◽

Judith Clare

Keyword(s):

Older People ◽

Discharge Planning ◽

Effective Discharge ◽

Liaison Nurse

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Effective discharge planning - timely assignment of an estimated date of discharge

Australian Health Review ◽

10.1071/ah09843 ◽

2011 ◽

Vol 35 (3) ◽

pp. 357 ◽

Cited By ~ 8

Author(s):

Lixin Ou ◽

Jack Chen ◽

Lis Young ◽

Nancy Santiano ◽

La-Stacey Baramy ◽

...

Keyword(s):

Emergency Department ◽

Logistic Regression ◽

Older Patients ◽

Discharge Planning ◽

Index Score ◽

Charlson Index ◽

Effective Discharge ◽

Delayed Discharge ◽

Chronic Morbidity ◽

English Speaking

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.

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The Role Of The Pediatric Nurse In Discharge Planning; Identifying Gaps In Sri Lanka

Indonesian Journal of Nursing Practices ◽

10.18196/ijnp.v5i1.10748 ◽

2021 ◽

Vol 5 (1) ◽

pp. 36-50

Author(s):

Kalpana Jeewanthi Subasinghe ◽

A.M. Shyama Deepanie Pathiranage

Keyword(s):

Sri Lanka ◽

Planning Process ◽

Transitional Care ◽

Discharge Planning ◽

Pediatric Population ◽

Discharge Process ◽

Sri Lankan ◽

Care Coordinator ◽

Pediatric Nurse ◽

Effective Discharge

Background: Pediatric discharge planning is a complex process, and that nurses need lengthy preparations. Role confusion among nurses will disrupt the smooth planning of the discharge. In Sri Lanka, although there is a possibility of reducing health costs through effective discharge planning led by pediatric nurses, it is questionable whether Sri Lankan nurses have clarified their role in this process.Method: This systematic review was conducted to map the different roles of nurses in the pediatric discharge planning process. Electronic databases of PubMed and CINAHL were searched for peer-reviewed journal articles among the pediatric population from 2005-2019, using the keywords such as discharge planning, pediatric nurse, care transitions, transitional care, and Sri Lankan nurse.Results: Articles that resulted in the word combination ‘Discharge planning and pediatric nursing (n=329) were used for screening. Two hundred and forty articles out of the nursing scope and sixty articles that do not describe an apparent nursing involvement in the discharge process were excluded, based on abstract review and full-text review, respectively. Sixteen studies were included in the final review. Few literature was found on the topic among Sri Lankan pediatric population. Four main categories of nurses’ roles were identified with the thematic analysis: discharge educator, discharge collaborator, post-discharge care coordinator, and family counselor. Conclusion: In Sri Lanka, no such defined roles of a nurse have been established yet in the discharge planning of pediatric patients. These roles may help nurses carry out discharge planning effectively, and future studies are needed on this topic in Sri Lanka.

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Improving patient care after a suicide attempt

Australasian Psychiatry ◽

10.1177/1039856218758560 ◽

2018 ◽

Vol 26 (2) ◽

pp. 145-148 ◽

Cited By ~ 7

Author(s):

Fiona Shand ◽

Laura Vogl ◽

Jo Robinson

Keyword(s):

Suicide Attempt ◽

Discharge Planning ◽

Psychosocial Assessment ◽

Coordinated Care ◽

Effective Discharge ◽

Effective Care ◽

Increased Risk ◽

Discharge From Hospital ◽

Improving Patient Care ◽

Risky Patients

Objectives: Improving the care that patients receive after a suicide attempt will reduce the risk of a subsequent suicide attempt. We described how care for these patients can be improved and identified the available guidelines. Methods: We reviewed the literature on crisis and aftercare, psychosocial assessment, risk assessment, brief contact interventions, and brief interventions. Results: People who have made a suicide attempt are at increased risk of suicide, and the period immediately after discharge from hospital is particularly risky. Patients require an empathic response at their first point of contact, comprehensive psychosocial assessment, effective discharge planning, rapid and assertive follow-up, and coordinated care in the subsequent months. Conclusions: Empathic and effective care that begins in the emergency department and extends through to community care is imperative. Enough is known about the risks of inadequate care and the key ingredients of effective care to proceed with changes to Australia’s healthcare response to a suicide attempt.

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Psychiatric Discharge Process

ISRN Psychiatry ◽

10.5402/2012/638943 ◽

2012 ◽

Vol 2012 ◽

pp. 1-7 ◽

Cited By ~ 4

Author(s):

Hamzah M. Alghzawi

Keyword(s):

Planning Process ◽

Discharge Planning ◽

Evidence Based ◽

Discharge Process ◽

Community Studies ◽

Inclusion Criteria ◽

Levels Of Evidence ◽

Effective Discharge ◽

Consensus Statements ◽

Acute Psychiatric Wards

Background. Integration of research evidence into clinical nursing practice is essential for the delivery of high-quality nursing care. Discharge planning is an essential process in psychiatric nursing field, in order to prevent recurrent readmission to psychiatric units. Objective. The purpose of this paper is to perform literature overview on psychiatric discharge planning, in order to develop evidence-based practice guideline of psychiatric discharge plan. Methods. A search of electronic databases was conducted. The search process aimed to locate different levels of evidence. Inclusion criteria were studies including outcomes related to prevention of readmission as stability in the community, studies investigating the discharge planning process in acute psychiatric wards, and studies that included factors that impede discharge planning and factors that aid timely discharge. On the other hand, exclusion criteria were studies in which discharge planning was discussed as part of a multi faceted intervention and was not the main focus of the review. Result. Studies met inclusion criteria were mainly literature reviews, consensus statements, and descriptive studies. All of these studies are considered at the lower levels of evidence. Conclusion. This review demonstrated that discharge planning based on general principles (evidence based principles) should be applied during psychiatric discharge planning to make this discharge more effective. Depending on this review, it could be concluded that effective discharge planning includes main three stages; initial discharge meeting, regular discharge meeting(s), and leaving from hospital and discharge day. Each stage of them has requirements should be accomplished be go to the next stage.

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