The goal of this exercise was to ensure that elements necessary for a successful discharge were viewed through the perspectives of interprofessional groups involved in the care of a patient. Provide patient, community pharmacy, PCP, and formal caregiver (family, LTC, home‐care agency) with copy of Discharge Summary Plan/Note and the Medication Reconciliation Form, and contact information of attending hospital physician and inpatient unit. Start early and use appropriate escalation channels The checklist was created using recommended human‐factors engineering concepts. a. Journal of Hospital Medicine 2013;8:444–449. At the first meeting, the panel reviewed existing toolkits and evidence‐based recommendations around best discharge practices. b. By Family Caregiver Alliance and reviewed by Carol Levine. 3. Comprehensive information and advice to help family caregivers and healthcare providers plan transitions for patients. You will need to check directly with the hospital, your insurer, or Medicare to find out what might be covered and what you will have to pay for. Reid, Diana BSN, RN, CCRN. We describe a structured approach to discharge planning, starting from admission and proceeding through discharge, using a standardized checklist of tasks to be performed for each hospitalization day.OBJECTIVETo create an evidence‐based checklist of safe discharge practices for hospital patients.METHODSIn the province of Ontario, the Ministry of Health and Long‐Term Care convened a panel of expert members from multiple disciplines and across several healthcare sectors. Daily teaching provides an opportunity to assess information carried over and accurate understanding of treatment plans, as well as to review changes in care plans that may be evolving during a hospitalization. Given the diverse interprofessional membership of the panel, it was felt that a daily reminder of tasks to be performed would provide the best format and have the highest likelihood of engaging team members in patient care coordination. That may take some coordination of discharge planning. This differs significantly from our discharge checklist, which provides specific recommendations on methods and processes to effect a safe discharge in addition to an expected timeline of when to complete each step. Think about both your needs as a caregiver and the needs of the person you are caring for, including language and cultural background. Medication safety a. What transportation arrangements need to be made? Figure 1 The checklist‐development process. The panel chose daily reminders to perform patient education around medications and clinical care for several reasons. Three cycles of checklist revision followed by comments and feedback were conducted after the meeting, through e‐mail exchange. 2004;52(7):1228], The care transitions intervention: results of a randomized controlled trial, Project BOOST: Better Outcomes by Optimizing Safe Transitions, Avoiding Hospital Admissions: Lessons From Evidence and Experience, How‐To Guide: Creating an Ideal Transition Home, Medication Reconciliation in Acute Care: Getting Started Kit, US Agency for Healthcare Research and Quality. a. [10] Individual items of the checklist may not have had an extensive evidence base; however, some of these suggested elements (eg, contact home care) have clinical face validity. It was also felt that daily interdisciplinary (ie, bullet) rounds would serve as the most appropriate venue to utilize the checklist tool.Table 1.Checklist of Safe Discharge Practices for Hospital Patients Day of AdmissionSubsequent Hospital DaysDischarge DayDischarge Day +3NOTE: Abbreviations: BPMH, best possible medication history; ED, emergency department; LTC, long‐term care, PCP, primary care physician.aLACE index is a score calculated based on 4 factors: (L) length of hospital stay, (A) acuity on admission, (C) comorbidity, and (E) ED visits. [21]The discharge process occurring during a patient's hospitalization is a complex, multifaceted care‐coordination plan that must begin on the first day of admission. You may have very little time and little information on which to base your decision. However, if something is determined by the doctor to be “medically necessary,” you may be able to get coverage for certain skilled care or equipment. Our discharge checklist prompts hospital providers to initiate steps necessary for a successful discharge while allowing for local adaptation in how each element is performed. 101 Montgomery Street | Suite 2150 | San Francisco, CA 94104 | 800.445.8106 toll-free | 415.434.3388 local. [17] Available toolkit resources including those developed by the Commonwealth Fund in partnership with the Institute for Healthcare Improvement,[18] the World Health Organization,[19] and the Safer Healthcare Now! 04/28/2020 07:48:56. Discharge Planning Plan early to reduce your chances of being readmitted and increase your chances for a healthy recovery. Note that this process includes at least one meeting between the patient, family, and discharge planner to help the patient and f amily feel prepared to go home. Engage home‐care agencies (eg, interdisciplinary rounds). A recent study in the New England Journal of Medicine concluded that one in five Medicare patients are readmitted to the hospital within 30 days. Provide patient, community pharmacy, PCP, and formal caregiver (family, LTC, home‐care agency) with copy of Discharge Summary Plan/Note and the Medication Reconciliation Form, and contact information of attending hospital physician and inpatient unit. You and your caregiver (a family member or friend who may . Follow‐up a.Perform postdischarge follow‐up phone call to patient (for patients with high LACE scoresa). A discharge‐checklist tool was created to facilitate safe discharge from hospital. Second, the heterogeneity of interventions studied pose challenges in determining generalizable best practices without considering local factors. [20] were examined in detail. To facilitate transfer of information, patients, caregivers, outpatient providers, and community pharmacies are to be provided copies of a comprehensive discharge summary, medication reconciliation, and contact information of the inpatient team under the category of Communication. facilitated the process (Figure 1). March hospitalization due to extreme hallucinations due to depression drug. Does my family member require help at night and if so, how will I get enough sleep? © 2013 Society of Hospital Medicine. First, current literature on safe discharge practices is limited by low study‐design quality, with a paucity of randomized controlled trials. The information below describes key elements of the IDEAL discharge from admission to discharge to home. We suggest you keep the questions summarized below (on pages 5–6 of the printout) with you, and request that the discharge planner take the time to review them with you. United Hospital Fund They are obliged to get a plan in place. We have used a consensus process of stakeholders to develop a Checklist of Safe Discharge Practices for Hospital Patients that details the steps of events that need to be completed for every day of a typical hospitalization. Are there special facilities/programs for dementia patients? The day of discharge is often a confusing and chaotic time, with patients receiving an overwhelming volume of information on their last day in the hospital. [17] Available toolkit resources including those developed by the Commonwealth Fund in partnership with the Institute for Healthcare Improvement,[18] the World Health Organization,[19] and the Safer Healthcare Now! Improve communication between hospital and community-based services. FCA CareJourney: www.caregiver.org/carejourney Consent. Jurisdictions in the ED to safe transitions for the additional hospital care, you have the to. 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