Remaining in the hospital
when a patient no longer requires an acute care setting puts them at risk for
many reasons: nosocomial infections, physical deconditioning, and decreased
mental status are some key examples. The longer the Length of Stay (LOS)
exacerbates these and results in poor clinical outcomes and dissatisfied
patients and families. In hospitals we, the care providers, are overwhelmed and are often task
focused, which prohibits us from not focusing on progression of care. We need to be go back to basics and put the
focus back on the patient and providing quality care.
Clinicians and Care Providers
Engage Earlier - start engaging the patient and the family about their goals of care on the day of admission.
Make Care Coordination Patient Focused in Real Time - assign a target Estimated Date of Discharge (EDD)
on the day of admission and continue to review it daily as the patients
progress through their care journey to discharge. Discharge can be to their home
or transition to an alternate care setting.
Be Proactive - discharge planning must be
proactive not reactive.
Identify Barriers and Delays on a Daily Basis - focus on patient flow daily to identify any
barriers, delays or interruptions in the patient journey. These barriers should be identified and acted
upon daily in real time to ensure the patient is receiving the best care, the
right level of care and having progress in their care path daily. Keeping patients involved in their daily care
and hospital LOS goals with improved communication and collaboration puts the
patient first and will improve patient satisfaction.
Standardize Processes - hospitals need to standardize their patient flow
processes, make them visible, and communicate across the organization.
Encourage Collaboration - embrace a culture where
every member of the Multidisciplinary team is involved in the care plan of the
patient which includes the discharge plan.
Although many hospitals now have discharge planners, social workers, patient
flow coordinators to facilitate discharge plans, it is still the responsibility
of all members of the care team.
Care delivered must be a value-add to the patient. We do not want our patients sitting around wondering what is happening with their plan of care. Communication is key among the care delivery team and, more importantly, with the patient and their family.
We have all heard the phrase "happy wife, happy life." For clinicians out there, "happy patient, happy nurse."