Discharge Rounding: A Case Study

Discharge planning is a routine feature of health in many countries. The aim of discharge planning is to reduce hospital length of stay and unplanned readmissions to hospital, to improve the co-ordination of services following discharge from hospital thereby bridging the gap between the hospital and community (S. Shapperd, 2008). The focus of this story is discharge planning that occurs while

CM spoke with Mr. Antunez regarding Devin transiting out of CMO. CM and Mr. Antunez discussed Devin’s growth throughout the year. CM explained to Mr. Antunez that Ms. Feliciano will link Devin to outpatient at Hoboken Medical Center or Jersey City Medical Center. CM stated that CM supervisor will also attend next month discharge meeting/ IEP meeting on October 7, 2016. Mr. Antunez agreed to Devin’s

PO is referred to continue chemical dependence treatment at the community agency. PO will need to have a new assessment to determine appropriate level of care. PO is recommended to attend minimally of two self-help meetings per week, abstain from all mood-altering substance, and utilize positive support structure to aim and maintain substance free lifestyle.

I forwarded the accounts with the information to the Appeal Coordinator (Ed), in which, Ed informed me to forward the information to Gail Belsik, of Patient Accounts, to obtain the required information and/or bill modification. Below, you will find Gail’s response.

Post-discharge follow-up visit remains a critical factor in ensuring that patients continue to do well after they leave the hospital. The success of the team was measured based on data collected after 6 months of revamping the discharge clinic and implementing a phone call system to patients. They had been given a choice of a phone call for discharge follow up or to come in within 7-14 days and be evaluated post discharge.

Handoffs during shift change between nurses is one of the most important ways to communicate essential information related to the patients’ care and their safety. This is an evidence-based practice that improves communication among nurses and patients since the handoffs are conducted at the patients’ bedside, face-to-face, with the computer using SBAR. The patients are involved in the update of their care with the incoming nurse, enabling them to share concerns and to add valuable information, which increases patients’ satisfaction. Additionally, during the handoffs, the nurses with the patients are able to review and update the patients’ white board with the goals, activities, procedures, labs, consults, and symptom management for the incoming

This study evaluated if changing the process of shift handover from traditional form conducted in an off stage area to handover at the bedside could lead to improved safety for patients and cost reductions by shortening the duration of handover. The researchers also examined staff perceptions and satisfaction with the traditional method of handover versus th

Deficiency of discharge planning can lead to lack of knowledge about diagnosis and confusion concerning medications. In a study researching patients being discharged from a teaching hospital in New York City, only 41.9% could tell researchers their diagnosis, 37.2% could remember the purpose of all their medications, and 27.9% could recite all their medications (Makaryus & Friedman, 2005). Insufficient

Communication of information between health care providers is a fundamental component of patient care. The information shared during the shift exchange helps to plan patient care, identifies safety concerns and facilitates

The process of conveying information regarding a patient’s condition from one health care provider to another is referred to as a “handoff”. The primary objective of a handoff is to communicate accurate information about a patient’s health status. Currently, at the White City VA Southern Oregon Rehabilitation Center and Clinic (SORCC), there is a lack of consistency in the documentation and verbal handoff reporting between the Registered Nurse and Provider during a patient triage visit. It is imperative to improve this process in order to have effective communication between the nurse and provider, as well as provide personalized and appropriate care for the Veterans we serve.

Line 7: Key in the insured's address and telephone number, if the address is the same as the patient’s enter SAME. Complete this item only when items 4 and 11 have been completed.

Traditionally, nursing shift-to-shift reports were organized methods of communication between only the oncoming and leaving nurse, designated to a location such as the central nursing station or nook of a hallway. Shift reports can be considered the foundation of how the day is going to plan out because it introduces the patient, diagnoses, complications, medications, consults, upcoming test and the entire plan of care. These reports are full of complicated and vital information and while set in certain locations that are vulnerable to interruptions, such as the nursing station, medical errors and miscommunication are more likely to be made. The Joint Commission’s 2009 and 2010 National Patient Safety Goals (Joint Commission, 2015) included two patient safety standards, first to encourage patients to be involved in their health care plan and second, to implement a standardized communication process for handoff reports between providers. Soon after in 2013, The Agency for Healthcare Research and Quality under the United States Department of Health and Human Services introduced a set of strategies to improve patient engagement along with safety and quality in patient care. Within these strategies the new method of nurse bedside shift report was developed, which suggests nurses to conduct shift-to-shift reports at bedside in the room of each patient, rather than out of the room. The benefits of this new method were

Clinical staff contributed to restrictive patient flow second to subjective treatment routines and subjective diagnostic and discharge patterns. Subjective diagnostic patterns created different workflow demands on Microbiology, Radiology, and Respiratory departments. Because each patient was subjected to different diagnosis, based upon subjective assessments by clinical staff, different patient flow patterns emerged. Simultaneously each shift of clinicians had a varying diagnostic wait time, treatment time, and time to discharge. Thus, the effectiveness and experience of clinical staff is directly related to their speed and accuracy of assessment, treatment, and discharge routines.

The hourly rounding log is designed in accordance with the hospital’s policies and procedures. A clinical committee is consulted in designing the documentation log to suit the needs of the patients and the staff. It is composed of four columns. The first column is the time period, the second is the actual time that the staff rounded the patient, the third is the staff’s initials who make the rounds, and the last one is for comments (any significant patient needs that were addressed or that patient is asleep).

In evaluating possible approaches to make the discharge process clear, easy and convenient for the patient and the staff, I looked into other