#NurChat to discuss “Effective Discharge” 28/02/2012 8pm
We are encouraged to ensure that our patients discharge is planned from the moment they are admitted and as nurses we are more than aware that a well planned discharge can help to minimise readmission in addition to increasing well being in both patients and their families. Department of Health guidance – Achieving timely ‘simple’ discharge from hospital states “what happens during the discharge process is a key part of patients’ experiences of hospital care” It goes onto state that “effective discharge is seen as less important than the admission process – we concentrate on the front end of the system (admissions) and not the back end (discharges)
Does discharge planning always happen? Are people still being sent home under resourced leading to further complications and readmission? Why do we still have “bed blockers”? How can nurses ensure that patients’ discharges are well planned and effective? What barriers are there to effective discharge planning and how can we resolve them?
Click on the picture to download a printable PDF for notice boards
Below are some links to background information, please feel free to add your own links too via the comments box.
Achieving timely 'simple' discharge from hospital - Department of Health
Discharge Planning - RCN
Discharge Planning - NHS Institute for Innovation and Improvement
What is the effect of discharge planning ? - Nursing Times
Implementing nurse led discharge - Nursing Times
Summary by Teresa Chinn RN
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Post Chat Summary
View the Nursing Times Blog for this post
This
NurChat focussed on the discharge of patients from hospital, this discussion
subject was suggested anonymously via the Nurchat blog. This was a lively and varied discussion with
nursing opinions from general nursing, community nursing, learning disability nursing
and mental health nursing. The chat
started by asking what constitutes a good discharge? Most participants were agreed on the main
points of good communication between the MDT the patient and any carers and
community services.
Poor discharges
were raised and it was mentioned that sometimes the focus is on hospital beds rather
than effective discharge and that often the next of kin are only informed and
not involved.
NurChat
asked if discharge was seen as less important than admission. Answers ranged
from both are equally important to discharge being the most important to a
patient and that good discharge planning should start at admission. The large
volume of admission paperwork compared to a discharge checklist were raised as
an issue and it was stated that in wales there is discharge paperwork to be
completed in the admission booklets.
NurChatters
were then asked if outside health care professionals and community carers were
involved enough in discharge? Some stated that no the community were not
involved, some stated that it was somewhat of a lottery depending on where you
lived.
Discharge
coordinators were discussed throughout the debate and it was mentioned that not
only are discharge coordinator good resources but also LD liaison nurses and Care
Coordinator in MH. It was mentioned that in some MH cases it is a legal requirement
to manage discharge.
It was
raised that in MH patients are often discharged back into an environment that
was contributing to their illness leading to repeat readmissions.
Discharge
lounges were discussed and these seemed to be used in a variety of ways – in some
trusts for a few hours care and in some for a few weeks care, more like
rehabilitation wards. A point was raised
that this helps to bring in admissions but does not necessarily get people home
safely.
Hospital
passports for people with learning disabilities were raised and were seen as a
helpful think during planning of discharge – a link was shared to a good
example http://t.co/oTiNqgfr
Nurse led
discharges were discussed – one participant stated that nurse led discharges
were often the best and others agreed adding that good discharge is all about
communication and nurses have the most communication with patients.
The chat
concluded by discussing Difficulties with patients being discharged to inappropriate
circumstances were from a community perspective and it was clear that
communication with the community is often lacking leading to the community
being unaware of the discharge and not ready. Also waiting for transport was
discussed and it was mentioned that this could often be days of waiting.
Summary by Teresa Chinn RN
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Chat Transcript (via Storify)
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