Patient Discharge Process: Discharge Risk Factors

Lesson Transcript
Instructor: Adrianne Baron

Adrianne has a master's degree in cancer biology and has taught high school and college biology.

This lesson is going to take an in-depth look at the patient discharge risk factors most commonly seen. We will discuss examples of each risk factor and see how they can result in readmission.

Patient Discharge

Whenever a patient is admitted to the hospital, everyone has one focus and concern. The focus is successful patient discharge, or the release of a patient from the hospital. You and the rest of the healthcare team are going to meet this focus through discharge planning, which is a plan of action to address the needs of the patient in the hospital setting and after discharge.

During the process of discharge planning, you want to make sure that you as a nurse and other healthcare workers are thorough enough to decrease the likelihood of the patient being readmitted to the hospital for anything related to the current hospital visit. You need to know and think about the potential risk factors for readmission as you are doing discharge planning. Let's review those risk factors now by looking at what is going on with our patient, Will.

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Risk Factors

Arguably, the most common risk factor for readmission is premature discharge and/or inadequate support following discharge. This risk factor has to do with the patient being released from the hospital before reaching an acceptable point in treatment or health status. This could happen to Will if he isn't fully assessed prior to discharge. Failing to recognize a potential future need may cause Will to have inadequate support after discharge.

A separate, but related risk factor is when a patient is discharged against medical advice. Will leads a very busy life and just wants to leave the hospital or refuse the treatment at the hospital. This is a huge risk factor in that the health care team realizes that Will is not up to a certain health status. There's a very good likelihood that the patient will return in a very short period of time for the same health concern, or one that is more complicated, due to failing to receive treatment sooner.

Another risk factor, insufficient follow-up after discharge, is one that you yourself may have experienced. Have you ever been told to make an appointment with your PCP about a week after being discharged from the hospital, but you didn't go because you felt better and didn't think there was a need to go? Patients do this all the time and it puts them at risk. This risk factor could be the fault of multiple parties. The hospital team could be responsible if information was not successfully communicated to Will regarding his need for a follow-up appointment with a primary care physician (PCP). Responsibility could fall on Will if he simply doesn't go to the follow-up appointment. It could be the fault of Will's caregiver if he or she fails to take will to the follow-up appointments.

Errors in treatment therapy is another risk factor that occurs frequently, resulting in patients coming back to the hospital. The biggest treatment therapy culprit associated with hospital readmission is medication. Will may experience side effects from the new medication that require medical attention. He could also overdose on the medications due to not understanding how to take new medications or by having more than one prescription for the same medication. His caregivers may have also failed to give him the prescriptions he needs to get his medications. This risk factor has implications beyond just readmission, since incorrect administration of medication can potentially lead to Will's death.

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