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Nursing Standard (Royal College of... Jul 2016Essential facts Delays in discharging older peo ple from hospital cost the NHS £820 million a year, according to a report from the National Audit Office (NAO). Last...
Essential facts Delays in discharging older peo ple from hospital cost the NHS £820 million a year, according to a report from the National Audit Office (NAO). Last year in acute hospitals, 1.15 million bed days were lost to delayed transfers of care, an increase of 31% since 2013. The NAO says rising demand for NHS services is compounded by reduced local authority spending on adult social care - down by 10% since 2009-10.
Topics: Aged; Aged, 80 and over; Health Expenditures; Humans; Length of Stay; Patient Discharge; State Medicine; Time Factors; United Kingdom
PubMed: 27380673
DOI: 10.7748/ns.30.45.15.s17 -
Nursing Older People Sep 2016Essential facts Delays in discharging older people from hospital cost the NHS £820 million a year, according to a report from the National Audit Office (NAO).
Essential facts Delays in discharging older people from hospital cost the NHS £820 million a year, according to a report from the National Audit Office (NAO).
Topics: Aged; Demography; England; Humans; Patient Discharge; State Medicine
PubMed: 27682377
DOI: 10.7748/nop.28.8.11.s10 -
Emergency Nurse : the Journal of the... Nov 2016Essential facts Delays in discharging older people from hospital cost the NHS £820 million a year, according to a report from the National Audit Office (NAO).
Essential facts Delays in discharging older people from hospital cost the NHS £820 million a year, according to a report from the National Audit Office (NAO).
Topics: Aged; Aged, 80 and over; Humans; Patient Discharge; Patient Transfer; State Medicine; Time Factors; United Kingdom
PubMed: 27830626
DOI: 10.7748/en.24.7.11.s11 -
Journal of Advanced Nursing Jun 2020The purpose of this study was to validate patient's primary caregiver and their nurse's perception of patient discharge readiness assessment and their association with...
AIMS
The purpose of this study was to validate patient's primary caregiver and their nurse's perception of patient discharge readiness assessment and their association with postdischarge medical consumption.
DESIGN
The study employed a descriptive research, prospective longitudinal study design.
METHOD
The study was performed in a ward of a medical centre in Taipei, Taiwan, from June 2017-May 2018. Obtained data were analysed using an independent t test, one-way ANOVA and logistic regression approach.
RESULTS/FINDINGS
The number of comorbidities and the number of days of hospital stay were positively associated with post discharge emergency room visits. Caregiver readiness for hospital discharge had significant negative correlation with patient's 30-day readmission. Both caregiver and nurse readiness for the hospital discharge scale score were not factors associated with the patients' 30-day emergency room visit.
CONCLUSION
Based on the research findings, to assess the discharge readiness as perceived by caregivers at patients' discharge is recommended.
IMPACT
Caregiver and nurse scores on readiness for hospital discharge showed a significant positive correlation. The higher the score of a caregiver's readiness for a patient's hospital discharge, the lower the 30-day readmission rate. Family-centred care enables patients to safely pass though the transition phase from hospital to community and reduces the postrelease consumption of medical resources. The discharge readiness perceived by caregivers should be included in any decision-making.
Topics: Adult; Aftercare; Aged; Aged, 80 and over; Caregivers; Female; Guidelines as Topic; Humans; Male; Middle Aged; Nursing Staff, Hospital; Patient Acceptance of Health Care; Patient Discharge; Patient Readmission; Taiwan
PubMed: 32056269
DOI: 10.1111/jan.14329 -
Southern Medical Journal Oct 2020
Topics: Humans; Insurance, Health; Patient Discharge; Reimbursement Mechanisms; Treatment Refusal
PubMed: 33005967
DOI: 10.14423/SMJ.0000000000001150 -
Narrative Inquiry in Bioethics 2020The 12 narratives highlight persisting structural failures of health care delivery systems, which marginalize and disempower patients. These systemic failures coalesce...
The 12 narratives highlight persisting structural failures of health care delivery systems, which marginalize and disempower patients. These systemic failures coalesce around three major, sometimes overlapping forces. First, financial incentives drive virtually every aspect of health care. Given high costs of doing business, private and public health care providers alike constantly maneuver to minimize financial risks. Second, upon hospital discharge, many patients fall through the cracks, as they transition from the silo of inpatient facilities into another and separate silo, community-based long-term services and supports. Patients leaving inpatient facilities can find themselves in environments ill-suited to support their needs. Third, structural forces affect communication between patients and their health care providers. In particular, major payors, notably Medicare, punish hospitals financially when patients are readmitted shortly after discharge, leading hospitals to prioritize pre-discharge communication. However, discharge planning is often inadequate, leaving patients without essential information to effectively manage their health.
Topics: Communication Barriers; Delivery of Health Care; Hospitals; Humans; Narration; Patient Discharge; Patient Transfer
PubMed: 33583853
DOI: 10.1353/nib.2020.0066 -
Current Opinion in Anaesthesiology Dec 2019Day surgery coming and leaving hospital day of surgery is growing. From minor and intermediate procedure performed on health patient, day surgery is today performed on... (Review)
Review
PURPOSE OF REVIEW
Day surgery coming and leaving hospital day of surgery is growing. From minor and intermediate procedure performed on health patient, day surgery is today performed on complex procedures and elderly patient and on patients with comorbidities. Thus, appropriate discharge assessment is of huge importance to secure safety and quality of care.
RECENT FINDINGS
Discharge has since decades been assessed on a combination of stable vital signs, control of pain and postoperative nausea and vomiting and securing that patients can stand walk unaided. There is controversy around whether patients must drink and void before discharge. The absolute need for escort when leaving hospital and someone at home first night after surgery is argued but it does support safety. Discharge is not being 'street fit,' it merely allows patients to go back home for further recovery in the home environment. A structured discharge timeout checklist securing that patients are informed of further plans, signs, and symptoms to watch out for and what to do in case recovery don't follow plans facilitate safety.
SUMMARY
Discharge following day surgery must be based on appropriate assessment of stable vital signs and reasonable resumption of activity of daily living performance. Rapid discharge must not jeopardize safety. Classic discharge criteria are still basis for safe discharge, adding a structured discharge checklist facilitates safe discharge.
Topics: Ambulatory Surgical Procedures; Anesthesia Recovery Period; Humans; Patient Discharge
PubMed: 31425193
DOI: 10.1097/ACO.0000000000000784 -
The American Journal of Medicine Jun 2021Approximately 1%-2% of hospitalizations in the United States result in an against medical advice discharge. Still, the practice of discharging patients against medical... (Review)
Review
Approximately 1%-2% of hospitalizations in the United States result in an against medical advice discharge. Still, the practice of discharging patients against medical advice is highly subjective and variable. Discharges against medical advice are associated with physician distress, patient stigma, and adverse outcomes, including increased morbidity and mortality. This review summarizes discharge against medical advice research, proposes a definition for against medical advice discharge, and recommends a standard approach to a patient's request for discharge against medical advice.
Topics: Hospitalization; Humans; Patient Discharge; Risk Factors; Treatment Refusal; United States
PubMed: 33610522
DOI: 10.1016/j.amjmed.2020.12.027 -
Internal Medicine Journal Jan 2016A potential barrier to patient discharge from hospital is communication problems between the treating team and the patient or family regarding discharge planning.
BACKGROUND
A potential barrier to patient discharge from hospital is communication problems between the treating team and the patient or family regarding discharge planning.
AIM
To determine if a bedside 'Leaving Hospital Information Sheet' increases patient and family's knowledge of discharge date and destination and the name of the key clinician primarily responsible for team-patient communication.
METHODS
This article is a 'before-after' study of patients, their families and the interdisciplinary ward-based clinical team. Outcomes assessed pre-implementation and post-implementation of a bedside 'Leaving Hospital Information Sheet' containing discharge information for patients and families. Patients and families were asked if they knew the key clinician for team-patient communication and the proposed discharge date and discharge destination. Responses were compared with those set by the team. Staff were surveyed regarding their perceptions of patient awareness of discharge plans and the benefit of the 'Leaving Hospital Information Sheet'.
RESULTS
Significant improvement occurred regarding patients' knowledge of their key clinician for team-patient communication (31% vs 75%; P = 0.0001), correctly identifying who they were (47% vs 79%; P = 0.02), and correctly reporting their anticipated discharge date (54% vs 86%; P = 0.004). There was significant improvement in the family's knowledge of the anticipated discharge date (78% vs 96%; P = 0.04). Staff reported the 'Leaving Hospital Information Sheet' assisted with communication regarding anticipated discharge date and destination (very helpful n = 11, 39%; a little bit helpful n = 11, 39%).
CONCLUSIONS
A bedside 'Leaving Hospital Information Sheet' can potentially improve communication between patients, families and their treating team.
Topics: Communication; Hospitals; Humans; Length of Stay; Patient Care Team; Patient Discharge; Patient Satisfaction; Professional-Patient Relations; Surveys and Questionnaires
PubMed: 26439193
DOI: 10.1111/imj.12919 -
Healthcare Policy = Politiques de Sante Nov 2016Discharge prediction is designed to streamline inpatient flow and reduce hospital overcrowding without adding capacity. This study's objective was to describe the... (Review)
Review
AIMS AND OBJECTIVES
Discharge prediction is designed to streamline inpatient flow and reduce hospital overcrowding without adding capacity. This study's objective was to describe the literature on discharge prediction and assess its usefulness in evaluating the implementation and outcomes of discharge prediction projects.
METHODS
The authors reviewed the current peer-reviewed and grey literature on discharge prediction projects in acute care hospitals. Project descriptions were analyzed using Donabedian's structure-process-outcome model for evaluating complex healthcare innovations.
RESULTS
The review revealed a paucity of literature on the use and effectiveness of discharge prediction. There is high variation in its use and generally poor reporting of both implementation and outcomes.
CONCLUSIONS
The literature on discharge prediction generally lacks the descriptive detail that would be useful to parties considering or planning a discharge prediction initiative. Further study is required to determine how best to integrate these prediction tools into acute care hospitals.
Topics: Adult; Critical Care; Decision Making; Female; Forecasting; Humans; Male; Middle Aged; Outcome and Process Assessment, Health Care; Patient Discharge
PubMed: 28032828
DOI: No ID Found