The Discharge Issue: When a Patient is Truly Ready

The transition from a hospital stay, to at-home care can be a tricky one. Deciding the proper time to discharge the patient is crucial, so it’s important to be able to make the right call when it’s time for your patient to come home. A few recent studies have shown that patients who are discharged too early can be at risk for a variety of health complications.

Discharges are so difficult simply because the patient plays a major role in when they should go home. It’s up to you and the rest of your medical team to truly decide whether or not the patient is ready to go home.

Discharge Readiness

            There are a few things to look for when deciding whether or not a patient is ready to be discharged. Not only must you be observant of their immediate health, but also you must make sure a post-discharge plan is in place so they can have an easy recovery period

Immediate Health 

            The number one factor to consider before discharging a patient is their immediate health. Asking questions about the patient’s pain, discomfort, and their mobility can help set a timeframe as to when to send them home. If a patient is recovering and still in need of medical attention (despite their protests) then you should continue to recommend a longer hospital stay. Explain to them that remaining in the facility will help to speed up their recovery time and allow you and your staff to provide the necessary medical care.

Working together with your staff will make for a seamless discharge

Factors to consider before discharge:

  • Patient cognitive status
  • Patient activity level and functional status
  • The nature of the patient’s current home and suitability for the patient’s conditions (eg, presence of stairways, cleanliness)
  • Availability of family or companion support
  • Ability to obtain medications and services
  • Availability of transportation from hospital to home and for follow-up visits
  • Availability of services in the community to assist the patient with ongoing care

Planning for Home 

            One of the biggest mistakes many patients will make is not having a plan in place for when they get discharged. Something as simple as securing a ride home can throw a wrench into the discharge process. Speak with the patient and his or her loved ones about getting the home ready for their return. Studies have shown that as many as 40 percent of patients over 65 had medication errors after leaving the hospital, and 18 percent of Medicare patients discharged from a hospital are readmitted within 30 days. A proper plan can include setting up a proper room for the patient, transportation home, a medication regiment, and scheduling follow-up appointments.

Discharging a patient is all about communication and teamwork. Working with your medical team, the patient, and their loved ones in crucial to a successful discharge. Avoiding readmission will benefit both your staff and the patient in the long run so getting it right the first time is key.

Author: Troy Diffenderfer

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