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Hospital Patient Discharge Process Best Practices Can Improve Health Outcomes
Hospital Patient Discharge Process Best Practices Can Improve Health Outcomes
Streamlining the discharge process presents upsides for hospitals as well as for patients as they move from an acute care environment to a skilled nursing facility (SNF), long term care, or even community-based care. Quality hospital discharge procedures can improve outcomes for patients, though unfortunately, the quality of the discharge experience can vary significantly from organization to organization. Fortunately, more and more hospitals are customizing their discharge planning into innovative roles and functions. To improve effectiveness, nurses and other members of the care team must ensure that every aspect of the patient discharge process is not only comprehensive but expedient, including their communication efforts.
One way to measure the effectiveness of the patient discharge process is by tracking a reduction in hospital readmissions, which, among other factors, is a national priority in regard to the country’s broader agenda for healthcare reform. So, while there are several factors that can affect the quality of the discharge, care team communication looms large according to the Center for Medicare and Medicaid Services (CMS), who provides best practice guidance for hospitals so they can improve or provide the best possible patient discharge practices.
Hospital Discharge Process Best Practices
CMS provides the following guidance to improve patient outcomes. The practices here are not required for compliance but may help hospital leaders improve discharge planning processes. CMS best practice discharge guidance includes the following:
- Ensure discharge practices comply with applicable federal civil rights laws, not leading to needless segregation.
- Use an abbreviated post-hospital planning process for certain categories of outpatients, such as patients discharged from observation services, from same-day surgery and for certain categories of emergency department discharges.
- Develop discharge planning policies and procedures with input from the hospital’s medical staff prior to review and approval by the governing body. Obtain input from patients and other healthcare facilities and professionals who provide care to discharged patients.
- If a patient exercises the right to refuse to participate in discharge planning or to implement a discharge plan, document the refusal in the medical record.
- Assume every inpatient requires a discharge plan to reduce the risk of adverse health consequences post-discharge and the risk of readmission. Create a discharge plan for the individual patient.
- Develop collaborative partnerships with post-acute care providers to improve transitions of care that might support better patient outcomes.
- Provide a discharge planning tool to patients and their families to reinforce the discharge plan and encourage their participation in developing the plan to prepare patients for a successful transition from the hospital.
- To ensure post-discharge care transition, schedule follow-up appointments with the patient’s primary care physician or practitioner and in-home providers of service as applicable; fill prescriptions prior to discharge; and follow up with phone calls to the patient within 24 to 72 hours after discharge. Finally, schedule follow-up appointments for ambulatory care services prior to discharge to reduce the likelihood of preventable readmission.
Each of these best practices should be taken seriously since the patient’s health outcomes depend upon the caregiver’s response and planning to post-acute care. However, these CMS-cited strategies are not all that’s required for patient discharge best practices. Clinical communication and collaboration solutions can also be beneficial.
The Benefits of Clinical Communication and Collaboration Platforms
Clinical communication and collaboration (CC&C) platforms are important to hospital infrastructure because they can improve operations and quality of care. For example, a Gartner report from 2018 found that clinical communication and collaboration systems are gaining traction in hospitals because of the increased use of mobile devices by healthcare professionals.
Clinicians are using clinical workflow solutions for mobile devices to give patients a better experience (in most cases). Mobile devices allow clinicians to review data on their devices throughout the day rather than wasting time logging into desktop systems every time they begin treating a patient. CC&C solutions help aggregate any disparate data into one location for review and processing, and even allow for telemedicine and virtual care capabilities, including remote consultations, visits and patient monitoring. The technology means providers can connect with patients post-care and can be vital to implementing value-based care initiatives because they “prevent redundancies among different clinicians treating the same patient and helps organizations avoid readmission fees.”
Clinical communication and collaboration platforms are critical, too, for healthcare organizations as they become real-time health systems (RTHS), which are responsive to patient needs. Likewise, CC&C technology coordinates activities between clinicians, staff and IT infrastructure systems, and assist hospital caregivers securely and quickly sharing data, such as text messages, documents, images, telemetry and audio files – especially important as part of the patient discharge process and follow up.
Additionally, clinical communication and collaboration platforms provide care organizations the ability to prepare for specific outcomes, provide faster transitions of care, reduce medical errors and work toward higher patient and provider satisfaction. For example, CC&C technology means hospitals can efficiently connect to an electronic health record while managing a wide range of clinical alerts, and placing calls using integrated VoIP technology.
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CC&C a critical point-of-care healthcare system
Gartner calls CC&C systems “critical point-of-care systems” used to coordinate activities between clinicians, staff and IT infrastructure systems. CC&C technology can reduce response time and can lead to faster patient discharges, the point of our conversation here.
However, data security is a major factor in the implementation of CC&C systems. The growth of mobile device usage in healthcare organizations, Gartner says, can create security issues for hospitals if they are not managed properly. Mobile devices also can function differently – based on brand and model – meaning coordination is required for information to be entered from a variety of technologies into a funneled endpoint. Thus, clinicians must have access to all of a patient’s information in real-time at the point of care and during the day of discharge.
“CC&C systems are not passive actors in this new operational and management paradigm, but rather a rich source of patient event data and encounter and engagement activity necessary to satisfy revenue, cost, quality, and patient experience expectations,” Gartner said in its report, and they can improve the hospital discharge processes.
Entities are moving toward technology that consolidates systems, standardizes data and automates processes, of course, to ensure that all users and systems communicate in real-time, which is a great benefit to clinicians and patients. Finally, streamlined, and direct clinical communication and collaboration can lead to faster patient care; but poor communication systems can impact discharge. How? Potential discharge delays.
Patient discharge can be influenced by a missing test result, delayed medication reconciliation, or failures of outdated pager technology. Robust, streamlined communication approaches can be the key to driving a better-coordinated discharge process for patients system-wide. Integrated communication platforms like CC&C also can connect providers for direct collaboration when overseeing patient care protocols. Images and test results can be securely forwarded from one provider to the next, meaning the most successful discharge transitions.
In addition to CMS’ discharge best practice recommendations, hospitals should also consider adding CC&C platforms to enhance and improve patient discharge practices.
Implementing a clinical communication and collaboration platform can help hospitals achieve immediately increased productivity while improving a task that might otherwise seem disparate from the communication process: patient discharge. Quality communication systems can be an important component of patient discharge best practices. Through the use of CC&C solutions, patients might also experience a reduction in their length of stay, while also experiencing improved outcomes.
As we’ve noted, a streamlined patient discharge process can be meaningful for patients moving from acute or long-term care to the home care environment. To maximize effectiveness, nurses and other members of the care team must ensure that every aspect of the patient discharge process is not only comprehensive but effective – including their communications.
Will O'Connor M.D., CMIO at TigerConnect
Will O’Connor, M.D. is the Chief Medical Information Officer at TigerConnect. As a physician executive with more than 20 years of healthcare experience, Will is a passionate advocate for rapid advancement across the healthcare industry.
Tags: home care, discharge process, hospital discharge, improve outcomes, day of discharge, care team, hospital to home, hospital readmissions, hospital discharge process best practices, discharge planning, Patient discharge