Adrianne has a master's degree in cancer biology and has taught high school and college biology.
The goal at the beginning of a patient's stay at the hospital is to get the patient well enough to get out of the hospital. This goal is a concerted effort among the entire healthcare team that takes care of the patient from the point of admission. The final decision for patient discharge, or the release of a patient from the hospital, is made by the attending physician responsible for the patient.
There are often many different concerns that must be addressed in order to make sure the patient is safely discharged and to reach the goal of minimizing the chance that the patient will have to be readmitted for the same or a related condition again within a short time frame.
The overall discharge process is the same for each patient, but the details may be very different depending upon the patient's overall health condition, living situation and other circumstances. Let's see how the patient discharge planning process works.
One of the responsibilities that you may have as a nurse is to plan every aspect of a patient being discharged from the hospital. Discharge planning involves knowing the physician's orders for the patient, which will detail everything that needs to happen with patients once they are discharged. The orders are essentially your guidelines for the discharge.
The first thing to plan is the destination for the patient after discharge. The physician may discharge the patient to go home or to a nursing facility, rehabilitation center, or some form of a group home. The patient's own home is usually the easiest destination since they already have space there.
Placing the patient in any of the other facilities means that you need to contact the facility and make sure they have a bed available. In addition to securing a bed for the patient, you must verify that the facility accepts the insurance under which the patient is covered.
The next step in discharge planning is sending the physician's orders over to the facility, caregiver and/or family. It is important to verify that all of the requirements for the patient will be able to be met when the patient is discharged. Medication orders should be communicated at this point, and caregivers should determine which ones need to be ordered from a pharmacy and delivered, and which ones are available at the facility or home already.
Once you have confirmed a spot for the patient and they have the doctor's orders, you need to arrange transport for the patient to the facility. Transport options may include patients transporting themselves, family transporting the patient, or transport using an ambulatory service. The type of transport will depend on the status of the patient and any required equipment to sustain the patient's current condition.
If transport involves anyone other than just the patient, then you need to schedule the patient pick up. Give the person or company that is picking up the patient the discharge time, discharge location and the destination for the patient. The insurance information should be given and verified when an ambulatory service is used to ensure they accept the patient's insurance.
You always want to be sure that your patients are educated on any conditions or diseases that they were diagnosed with during hospitalization. Patient teaching should include an explanation of any and all diagnoses, the treatment plan including how and when to take medications, possible side effects of treatments, follow-up appointments, and any signs and symptoms for which they should seek immediate medical care. Patient teaching is an important part of the discharge process since it will increase the likelihood of the patient not being admitted again.
Once everything has been set up and explained, make sure the patient, caregiver or healthcare proxy signs the discharge instructions information sheet. Their signature documents that they received the instructions from the doctor on what should happen after they leave the hospital.
We had a chance to see everything that goes into the discharge planning portion of the discharge process. Patient discharge means to release a patient from the hospital. Let's do a quick glance back at what we discussed today.
- The first thing to plan is the destination for the patient after discharge. Destinations may include home, nursing facilities, rehabilitation centers or group homes.
- The next step is to send the physician's orders over to the facility, caregiver and/or family. It is important to verify that all of the requirements for the patient will be able to be met when the patient is discharged.
- The third step is to arrange transport for the patient to the destination. Transport options may include patients transporting themselves, family transporting the patient or transport using an ambulatory service.
- Patient teaching is the next part of the discharge planning. Patient teaching should include everything about the diagnosis and treatment plan as well as what to look out for that could require medical attention.
- The last part of discharge planning is to make sure the patient, caregiver or healthcare proxy signs the discharge instructions information sheet.
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