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LinkedIn debate: Hospital discharge should start at admission

2 Jul 2013, by Informa Insights

Reducing Hospital Readmission and Discharge Planning“The main challenges in discharge planning are likely to continue because of the increasingly ageing population and the stretched health dollar”, said Glenda Kerridge, Social Work Manager at the Australian Association of Social Workers in a recent interview with IIR Healthcare. We have asked members of our Healthcare Professionals group on LinkedIn what they consider key elements in hospital discharge planning. We have summarised some of their responses.

“I know it is always said that discharge should start at admission but this does not happen in all cases. There is often a mad rush just before discharge to line up accommodation, community supports and family meetings. Whether this is a resource or practice issue, it needs to be addressed at a matter of urgency. A rushed discharge from an inpatient unit to us does not allow enough time to inform/educate the client about their medication. Clients and their families also need to receive a clear explanation of the purpose of the rehabilitation process and the eventual community follow-up to minimise the risk of readmission.”
Senior Clinician, Monash Health

“A successful hospital discharge considers all relevant matters which will prevent an unplanned readmission. Different patients have different needs but in general older patients have more complex needs and require more supports after discharge. A successful discharge also provides seamless care back to the community and this involves exceptional communication with all community care providers.

As a pharmacist I found that often doctors left writing the discharge prescription until the patient was ready to leave. This made it very difficult to ensure that the patient was adequately educated and able to manage their medication in the community. Often issues such as ongoing monitoring of medication management in the community were treated as afterthoughts by other members of the healthcare team who just assumed that it was a matter of labelling a few packets and sending the patient on their way.

 There is always such a pressure on beds (another limited resource) that patients are discharged as quickly as possible to make the bed available for someone waiting in the ED. Unfortunately this is short sighted as the discharged patients are frequently readmitted later.

However that said health budgets are a bottomless pit especially with our ageing population. As a community we need to think about our priorities in health spending.”

Consultant Pharmacist, MediCom

“We continually see older persons with complex needs discharged back into the community with very little thought and planning as to how their very individual needs are going to be supported. The really critical issues such as support for returning home as a single individual sometimes with little or no family support and insufficient community supports continue to be areas which are not adequately provided for on discharge often causing re-admission. Advocacy for the patient at the discharge planning stage can also be an issue.”

General Manager, Jewish Community Services

 Healthcare Professionals Australia is a discussion and networking group for the healthcare industry in Australia. Whilst the geographic scope is defined to keep discussions relevant to Australia, membership is welcomed from across the globe. You can join the debate here.

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