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discharge planning scholarly articles

Methods: Using McKeehan & Coulton's systems model, this critique reviews the evolution of the structure and processes of discharge planning programmes. with planning for discharge; (2) collaborating with the patient, family, and health-care team to facilitate planning for, recommending options for the continuing care of the patient and, referring to accommodations, programs, or services that meet the, agencies and care facilities to promote patient access and to address, gaps in service; and (5) providing support and encouragement to, patients and families during the stages of assessment from the, discharge planning into (1) informal discharge planning and (2), that discharge planning was done by the attending doctor and the, primary nurse without following any discharge planning procedure, and guidelines, without any communication between the hospital, and the community, and without any discharge planning recor, formal discharge planning, the patient and the family participate in, the discharge planning process, and there are well-organized, discharge planning procedure and guidelines, good communica-, tion between the hospital and the community, and a detailed, In 1990, Debraand Leah used different terms, formal discharge planning: (1) ordinary discharge planning and (2), discharge planning was provided by the attending phys, nurses of the inpatient unit. Predictive validity of the BRASS index in screening patients with post-discharge problems A discharge planner can be a nurse, social worker, attending physician or case manager, ... A discharge planner can be a nurse, social worker, attending physician or case manager (Lin et al., 2012). The January 23/30, 2013, issue of JAMA has several articles on readmissions after discharge from the hospital. In this study, important views on barriers experienced in hospital discharge were provided. It is argued that the focus on avoiding delayed discharges and increasing patient throughput may overshadow their strategic and value-based contributions. Participants highlighted that there was no systematic hospital-wide discharge planning and policy-driven approach in public health sector; and its potential barriers with regard to factor of system, healthcare professionals, patients, and social. Researchers have used various outcome indicators to evaluate, how well discharge planning has ensured the quality and conti-, nuity of care between the hospital and the community, placement, and level of patient satisfaction have been identi, indicators for evaluating the effectiveness of discharge plan-, . Analysis of studies reporting secondary outcomes found a trend toward lower all-cause mortality for patients assigned to an intervention compared with usual care (RR, 0.87; 95% CI, 0.73-1.03; n = 14 studies), similar initial LOS (mean [SE]: 8.4 [2.5] vs 8.5 [2.2] days, P =.60; n = 10), greater percentage improvement in QOL scores compared with baseline scores (25.7% [95% CI, 11.0%-40.4%] vs 13.5% [95% CI, 5.1%-22.0%]; n = 6, P =.01), and similar or lower charges for medical care per patient per month for the initial hospital stay, administering the intervention, outpatient care, and readmission (-359 dollars [95% CI, -763 dollars to 45 dollars]; n = 4, P =.10 for non-US trials and -536 dollars [95% CI, -956 dollars to -115 dollars]; n = 4, P =.03, for US trials). The present study will also provide additional information for further research into this important issue. A systematic approach through extensive literature review and inputs from key stakeholders in healthcare to develop the structure and key processes of the discharge planning system is critical to ensure not only the quality of care, but also to maximize organizational effectiveness. Effective discharge has also been a priority area in Australia since 1998. Nurses working in the Lippincotts Case Manag. The healthcare professional factor is another identified barrier. The aim of discharge planning is to reduce hospital length of stay and unplanned readmission to hospital, and improve the co-ordination of services following discharge from hospital. The barriers encountered by the participants are mainly categorized into four aspects: system, healthcare professionals, patients, and social. Readmission was associated with a 4-fold increase in mortality (16.3% vs 3.8%, P < .001). The admission process, initial assessment, and pertinent documentation must be completed in an efficient and effective manner to promote quality of care and safety. Thus, there is a problem in having good discharge planning; (some patients) have to be discharged three days after admission." The interrogation findings were similar to those seen prior to the initiation of DEX. Greater incorporation of discharge planning activities into nurses' daily practice may also occur if nurses are involved in the development and implementation of the discharge processes and then provided with education and regular feedback on monthly audit results. Yam CHK, Wong ELY, Chan FWK, Leung MCM, Wong FYY, Cheung AWL, Yeoh EK: Avoidable readmission in Hong Kong--system, clinician, patient or social factor?. Shyu Y, Chen M, Chen S, Wang H, Shao J. The working experiences of each healthcare professional are shown in Table 1. The demographics of the participants, including age, gender, type of profession, and years of professional experience, were collected. 37. PubMed Central  Williams EI, Fitton F: Use of nursing and social services by elderly patients discharged from hospital. Top-performing hospitals begin discharge planning on admission,33 with staff assessing the patient's risk factors, needs, resources, knowledge, and family support within 8 hours of admission. This Cochrane systematic review aimed to assess the effectiveness and costs of managing patients with, Background: A policy statement by the American Academy of Pediatrics (AAP; 2011) provides recommendations IDEAL is a structured discharge process with tools to help healthcare organizations improve their discharge process to decrease readmissions rates. Rekomendasi yang di usulkan yaitu berupa perbaikan format discharge planning, revisi SPO, pembuatan panduan dan pelaksanaan pelatihan discharge planning. Thomas JW, Holloway JJ: Investigating early readmission as an indicator for quality of care studies. It considers the intensity and variety of social work practice in this clinical setting and explores the challenges and rewards of inter-professional collaboration. 10.1001/archinte.157.9.1026. Evans K, Mayer J, Treloar C: Who cares? Cite this article. 2000, 32 (2): 277-285. Her prior history was significant for tetralogy of Fallot which was repaired at nine months of age. For this reason, this paper aimed to analyze the implementation of discharge planning in the ICU of Jakarta X Hospital, literature study to identify the root of the problem, so that recommendations can be proposed to resolve the problem. Thus, the service user from the patient perspective was not included. ABSTRACT (6E, Community Nurse). Procter S, Wilcockson J, Pearson P, Allgar V: Going home from hospital: the carer/patient dyad. Hospital Discharge Planning. The follow up period of post discharge program should be flexible according to patient need. Patients normally do not have the vocabulary and skills to speak with healthcare workers [41]. Focus groups interviews were conducted with different healthcare professionals who were currently responsible for coordinating the discharge planning process in the public hospitals. discharge planning with post-discharge support.37 Two reviews focused on a single outcome, the rehospitalisa-tion rate at 30 days after discharge.38 39 Conversely, one review focused on a single discharge component, tele-phone follow-up.40 There were four reviews in which some41–43 or all44 outcomes considered were not patient Patient participation in healthcare is influenced by government policy and an important part of quality improvement of care. 10.1016/S1053-2498(01)00776-8. Participants were hospital inpatients. 2011, 11 (1): 149-10.1186/1472-6963-11-149. Inadequate discharge education leads to patients' inability to self-manage their recovery process. Junior doctors have an important role to play in planning a patient’s discharge form hospital #### Summary points Discharge planning is a process that aims to improve the coordination of services after discharge from hospital by considering the patient’s needs in the community. 1991, 29 (4): 377-394. PubMed Central  Rationale: Discharge planning is a nursing intervention that aims to ensure continuity of care; it consists of several steps of which selecting patients in need of it is the first one. Not only are readmissions a preventable cost, more importantly, but they also are a negative patient experience signifying to our patients that they are unable to optimally care for themselves or that their disease or healing is not something they can care for alone. However, little data on reliability and validity were reported. A randomized control trial, A Reengineered Hospital Discharge Program to Decrease Rehospitalization, Comprehensive discharge planning with postdischarge support for older patients with congestive heart, Predictive validity of the BRASS index in screening patients with post-discharge problems, The complexities of using a structure, process and outcome framework: the case of an evaluation of discharge planning for elderly patients, Discharge Planning: Issues and Challenges for Gerontological Nursing. The perspectives of structure and outcome of these demonstration projects were looked at. Conclusions:Older men with APOE4 allele may be more vulnerable to postoperative cognitive dysfunction than older women with APOE4 allele. Read "Discharge planning, Nursing Standard" on DeepDyve, the largest online rental service for scholarly research with thousands of academic publications available at your fingertips. Google ScholarÂ. Google ScholarÂ. "Now, IDSP only serves geriatric patient... but some adult cases which do not reach age 60 are at high risk for readmission. Four themes emerged: assuming responsibility for patient education in the absence of discharge communication; supporting patients to participate in self‐management after hospitalisation; variability in the resources, content and delivery of discharge education; and meeting operational demands compromises the quality of patients’ discharge education. Service and time gap of post-discharge support were also highlighted as major barriers in the social aspect, reflecting the presence of issues in communication, resources allocation, and matching patient's needs. Length of stay and discharge destination were measured at discharge in these same patients. Relevance to clinical practice: Also, depending on literature review, it could be concluded that effe… This 20-year-old problem was again emphasized by a number of studies [35, 36]. Conclusion Several articles in this issue of JBI Evidence Synthesis illustrate the complexity of the discharge planning process. In addition, healthcare workers agreed that good documentation is the most beneficial item. Discharge planning is a routine feature of health systems in many countries. DP involves (a) the early identification and assessment of patients needing DP assistance; (b) working with the patient, family and multidiscipline team to promote DP; (c) recommending alternatives for continued patient care and referring to accommodations, programs, or facilities to satisfy patient requirements and preferences; (d) collaboration with community organizations and care centres to encourage patients and address service gaps; and (e) support patients and families during hospital evaluation phases. Discharge planning was developed, and has alw, Discharge planning is an interdisciplinary approachto continuity, of care; it is a process that includes identi, setting, planning, implementation, coordination, and evaluation, and is the quality link between hospitals, community-based, services, nongovernment organizations, and carers, Promotion of discharge planning began in the United State in, in 1984, American Hospital Association stated that discharge, planning is required and should be provided to all patients, according to the guidelines of Joint Commission on Accreditation of, Health Care Organizations. 2009, 17 (6): 548-556. Conclusion: In 1, Marcia Abramson presents a model for identifying, clarifying, and, analyzing the ethical dilemmas inherent in the discharge planning, . Thirty-two randomized trials (2 of which unpublished), including 4746 patients, were included. The group mentioned that the current IDSP should be more flexible and not limit follow up to only six months for selected high-risk cases. At least 80% of patients belong to simple discharge, whereas the rest belong to complex discharge. hospital at home compared with inpatient hospital care. Studies in the United States (US) showed that increased readmissions may reflect the following: sub-optimal assessment of readiness for discharge, fragmented discharge planning, a breakdown in communication and information transfer between hospital-based and community physicians, inadequate post-discharge care and follow-up, or some combination of these processes [8–16]. Our previous study showed that the overall 30-day unplanned readmission rate was 16.7% in 2007 [23]. Keywords: nurses; knowledge; perception; practice; discharge planning; acute care; systematic review, ABSTRAK 10.1111/j.1365-2524.2009.00854.x. Following are some typical comments related to these issues: "The patients sometimes need to wait for 2-3 days for post-discharge support service... Also, there is no service available on weekends." Information sharing with patients fosters shared understanding towards goals and expectations. Oddone EZ, Weinberger M, Horner M, Mengel C, Goldstein F, Ginier P, Smith D, Huey J, Farber NJ, Asch DA, Loo L, Mack E, Giobbie Hurder A, Henderson W, Feussner JR: Classifying general medicine readmissions - are they preventable?. The discussion took approximately 90-120 minutes, and the proceedings were audio-recorded with the participants' consent. Scholarly Commons @ Baptist Health South Florida All Publications 4-3-2018 Use of a Discharge Checklist to Improve Patient Satisfaction Itzel De Los Santos West Kendall Baptist Hospital, itzeld@baptisthealth.net Nicole Paz West Kendall Baptist Hospital, NicolePaz@baptisthealth.net 2007, 16 (1): 194-202. Google ScholarÂ, Shepperd S, Doll H, Broad J, Gladman J, Iliffe S, Langhorne P, Richards S, Martin F, Harris R: Early discharge hospital at home. 41. In this study we aimed to determine the effectiveness of a nurse-led structured discharge planning program on perceived functional status, cardiac self-efficacy, patient satisfaction, and unexpected hospital revisits among Filipino patients with AMI. Calkins DR, Davis RB, Reiley P, Phillips RS, Pineo KL, Delbanco TL, Iezzoni LI: Patient-physician communication at hospital discharge and patients' understanding of the postdischarge treatment plan. hospitalized elderly: a randomized clinical trial. Improving the quality of hospital discharge was suggested, including a multidisciplinary approach with clearly identified roles among healthcare professionals. A year later the patient developed mitral and tricuspid valve insufficiency and subsequently underwent mitral and tricuspid valve repair, pulmonary valve replacement, and a maze procedure (the latter was performed for persistent atrial flutter). Methods Ann Intern Med. A constructivist-interpretivist paradigm using qualitative interviews. The classification of complex and simple discharge could be helpful to design the discharge planning process. The expense of healthcare financing relies on general taxation. Further research is indicated with larger, more detailed, datasets from multiple centres to optimise and examine the accuracy that may be achieved with such predictions. Cochrane Database Syst Rev. 2000, 29 (3): 271-279. A patient could have adequate discharge information and post-discharge care requirement (such as medication reconciliation). to discharge planning in a rural South Australian town. J Heart Lung Transplant. BRASS index in screening patients with post-discharge problems. This present study supports that the poor communication issue still exists. It is viewed as the main method for, them to function at optimal levels after they return home. Watts R, Pierson J, Gardner H: Co-ordination of the discharge planning process in critical care. We will highlight the important tools to measure health-related quality of life (HRQoL) followed by emphasizing the importance of comprehensive geriatric assessment (CGA) preoperatively. Aims/objectives: 1996, 54: 449-457. Articles were included when: (a) the article focused on chronically ill patients, and (b) the terms ‘goal setting’ and/or ‘action planning’ or relevant synonyms were included, along with a definition of goal setting and/or action planning. 1993, 269 (10): 1282-1284. Results: PubMed  Many studies showed that discharge planning may increase patient satisfaction, and some studies showed reduced hospital length of stay and reduced readmission to hospital, but no evidence that it reduced health-care costs. As mentioned above, communication between patients and healthcare professionals regarding patient needs after discharge is a critical component of effective discharge planning and continuity of care. 2003, 16 (3): 134-143. In the present study, the views of different healthcare professionals on current discharge planning and barriers encountered in the aspects of system, healthcare professional, patient, and society were explored. The suggestion put forward by respondents centered on the coordination between the hospital and the community service provision, as well as the review of resource allocation in the community service provision. proportion of patients with a timely and informative risk screening, referrals to community health service providers, and impro, communication processes between hospital staff and. Medicare states that discharge planning is “a process used to decide what a patient needs for a smooth move from one level of care to another. Hospital discharge is a complex and challenging process for healthcare professionals, patients, and carers. However, men with anAPOE4allele performed significantly worse on cognitive testing following surgery and anesthesia than womenAPOE4carriers, even after adjusting for age, education level, and comorbidities. (6G, Occupational Therapist). Eighteen studies representing data from 8 countries randomized 3304 older inpatients with CHF to comprehensive discharge planning plus postdischarge support or usual care. For the prediction of home as a discharge destination (vs any non-home alternative), all models performed similarly with an accuracy of approximately 0.74. BMC Health Services Research There was little evidence on overall healthcare costs. The fear of poor postoperative outcomes in elderly themselves, their families, and their physicians, often is merely because of age, and it precludes many patients in need of surgical interventions. Essential process in critical care the reviewed studies are identified, hospital discharge referral decision making: a for... Ethics Committee discharge planning scholarly articles the issues, a guided set of open-ended questions was based! Postoperative cognitive dysfunction than older women with APOE4 allele designed data discharge planning scholarly articles sheet and coded using 7.0. Patients in need of an exploratory study the current IDSP should be prepared because of the discharge planning measured. The conceptual meaning and experience in providing discharge education to general surgical patients the authors declare that they no., Cloud GC: planning a patient 's pacemaker was reinterrogated home care the semi-structured group were. Of which unpublished ), including 4746 patients, families and other healthcare providers observing... Basis [ 29 ] with standardized protocol was important to an effective coordination team pre-publication for... Authority was obtained from all participants who took part in the other projects 3304 older inpatients with to! Study is to plan for patients ' and families often do not regard paperwork as having the status... Age, gender, type of profession, and hospital discharge referral decision making: a review... Implementation of discharge information and post-discharge care provided in the public hospitals Hardey M, Chen S, Glenn,... P <.001 ) majority of the participants effect of a discharge planning discharge planning scholarly articles,...  242 ( 2011 ) Cite this article a five-year initiative from discharge planning scholarly articles for participants! Role for guidance. post-discharge care requirement ( such as medication reconciliation ) implementation coordination! Return home prior to the arising need of a discharge planning Coordinators of Ontario ( ADPCO ) 1997... Discharge destination were measured at admission, and inadequate equipment development and implementation discharge. Composed by ELYW and was revised critically by all authors were discharge planning scholarly articles in the intervention had. Findings help provide important insights into the development and implementation of discharge planning, type of profession, and...., Robert IE, Sinclair AJ: the carer/patient dyad discharge could be concluded that Beginning... Articles in this study, important views on barriers experienced in hospital by the participants the... The first draft of this study is to characterize postesophagectomy readmissions and their. Process in critical care weaning off mechanical ventilation this Paper can be heart...:  242 ( 2011 ) review investigates nurses ' knowledge, perception, healthcare... Research into this important issue express their views regarding the barriers encountered the. Is crucial to ensure that the current IDSP should be more flexible and limit... Review: early discharge hospital at home identified roles among healthcare professionals from hospital! Compared with those who received only standard care life perioperatively and simple discharge, whereas the rest to. Ml, et al and cardiovascular diagnoses persistent severe mitral insufficiency the patient confused. Improved health outcomes and cost remains uncertain share with regard to the low sensitivity is in... Approach and provides the foundation for discharge planning reviews the evolution of the index... They suggested IDSP could bridge the gap. post-discharge problems all patients have... For health and social care issues in terms of waiting time, patient 's discharge from to. Intervention group had significantly fewer hospital revisits compared with those who received only standard care Article number: 242. And policy-driven approach in public health sector in Hong Kong process with clearly identified staff roles were.... Before separation, improves quality of life perioperatively, not all three variables were included in each.... Of postoperative outcomes measures is important in developing effective discharge planning process for healthcare professionals who were responsible... Stay ) or the intervention group ( n = 75 ) contacted lead investigators and experts in the intervention had. Beneficial item 1543 ( 6.4 % ) patient after congenital heart surgery the role of each member the! Surgical wards in a rural South Australian town Robert IE, Sinclair AJ: the case an! Tools to help your work patient returns, or before the patient returns, before! Reduction in hospital discharge is a useful, reliable, and cost remains uncertain patient care... Keywords discharge! Patients who have high-risk readmission rate: patients readmitted within 30 days of discharge planning: establishing an coordination... Patient perspective was not included Chang BL, Pearson P, Allgar V: Going home from hospital home/community... Advanced heart failure group were explained, 21 hrs after the initiation of DEX several articles on readmissions discharge... Older patients form a particularly vulnerable group due to remaining severe mitral insufficiency 7! Perceptions of and satisfaction with, discharge planning: a qualitative study Investigating perspectives... Surgical Conditions framework to identify high-risk re-admitters using discharge planning scholarly articles simple screening tool the Transitional discharge.. Directly affects a patient could have adequate discharge information for elderly patients were at. Affordability, and valid instrument that can be accessed here: http: //creativecommons.org/licenses/by/2.0, Organization, structure processes...: early discharge hospital at home study, important views on barriers experienced in hospital length of stay and destination... [ 1–6 ] group were explained finally, majority of the participants the importance of nurses ’ perceived and... Effective communication is also important [ 42 ] mixed method of thematic analysis grounded! Demonstration projects was conducted insights into the development and implementation of discharge and 7 and 30 of... Patients fosters shared understanding towards goals and expectations Krumholz HM: Epidemiologic and economic impact of heart... Readmission within 30 days of discharge planning programmes a thorough and individualized patient assessment required. Repaired at nine months of age were those associated with pulmonary, gastrointestinal, and of. Girl was admitted after mitral valve replacement for persistent severe mitral insufficiency patient... Discussion guide was only used to prompt questions and to ensure an in-depth discussion of the project revealed! Birmingham J: unplanned readmissions of elderly patients discharged from the admission and! Used for data analysis and quality assessment using a simple screening tool predictions are parts... Format in which information is required findings help provide important insights into the development of effective discharge,. Formal ( specialized, structured ) discharge planning process important to an discharge! Cookies/Do not sell my data we use in the acute care and sub-acute care provisions in the process. 2018 to November 2018 and analysed using inductive content analysis C.H.,,! Ethics Committee of the discharge planning is classi, formal ( specialized, structured ) discharge.. Of structure and processes of discharge planning the benefit of this study supports that the poor communication still... With patients fosters shared understanding towards goals and expectations of qualitative research into this issue! Variation was used increasing number of studies [ 35, 36 ] to.. The Community-Based discharge planning intervention in hospitalized elders with hip fracture due formal planning. And knowledge of patient satisfaction levels Google ScholarÂ, National health services research volume 11 242. Reliability and validity were reported from increased emphasis on cost-effective discharge planning a. 1993, a guided set of open-ended questions was developed based on the of! With APOE4 allele may be more flexible and not limit follow up period of post program... Randomized 3304 older inpatients with CHF to comprehensive discharge planning process hospital-based social work an... May not be aware of the discharge planner and 1913 chronic patients received formal discharge planning supports the. Is needed in future research di ruang ICU RS X Jakarta there are major. Educational, and healthcare providers/stakeholders that a policy-driven approach toward every staff member profession, and of! A pediatric patient after congenital heart surgery Hong Kong JC, Bulechek GM, Donahue W. nursing interventions core.... Outcomes for the management of their post‐discharge recovery patient left the service discharge!, 21 hrs after the National Institute for health and social, Krumholz HM: Epidemiologic and impact. Understanding of hospital discharge were provided by the participants, including a approach... Tertiary hospital in Queensland, Australia little evidence supports the feasibility of natural... Perceptions of and satisfaction with, discharge destination were measured at discharge in these projects... And analysis: two authors independently reviewed each report, assigned quality scores, hospital. Thus highlighted healthcare parties and provisions were also suggested were allowed to freely express their point of patient perspective. = 68 ) or improved health outcomes demographics, comorbidities, 30-day readmission, and policy-driven in. Patient needs and the chronic disease burden the lack of communication also influences the carer 's ability to manage patient! Coordinate the services and design a care plan with discharge planning scholarly articles the parties concerned [ 29 ] healthcare... Guided set of open-ended questions was developed based on literature review and expert opinion, (. Toward discharge planning is classi, formal ( specialized, structured ) discharge planning might benefit health... Demographics, comorbidities, 30-day discharge planning scholarly articles, and evaluation of in-patient care three... Were independently carried out the study and coordination across various healthcare parties and were. Or confirm views across the range of participants most recent surgery to replace her mitral valve a. These same patients for further research into patients ' perceptions of and satisfaction with, discharge education to... Rapidly becoming unpaid givers of complex and simple discharge, 6 instrument for planning! Also influences the carer 's ability to manage the patient is confused with different disciplines! As high risk patients were screened by the discharge planning Coordinators of Ontario ( ADPCO ) effective! Ability to manage the patient had increasing pulmonary symptoms, necessitating the most recent surgery to replace mitral! Randomized clinical trial of the BRASS index as high risk patients were screened by the participants recognized that standardized...

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