Discharging a patient from a hospital setting should be very easy, according to all of the patients that are in the hospital and don’t care about anything at the moment except getting home. While the patient is inpatient there are many things that could go wrong, however in house the patient is being controlled and managed. When a patient goes home there are no monitors or hourly blood draws to ensure their safety and survival. Discharge planning is not easy, and should never be perceived as such. Hospitals must have certain policies in place to ensure the patient and the family understand what to do when they go home, in regards to medications, therapy, etc. In order to meet conditions for discharge planning the hospital must be able to define how the obligation is to be met, determine readiness for discharge, identify who is responsible for the discharge. In order to determine a patient is ready to be discharged, the patient must be no longer in need of acute care services and the patient’s needs for post-acute care services have been identified and plans have been made.
Hospitals have a legal obligation to assess the patient’s medical status at time of discharge, take steps to identify appropriate community services that can meet the patient’s needs, and make reasonable attempts to make services known and available to patients. When a patient goes into the hospital they are looking for their life to be saved because of some medical issue. A doctor looks at the patient and determines the medical plan for that patient to stabilize the patient. This could include tests, surgery, medications, etc. While the patient is in the hospital they get transported to and from, unknown medications are provided to stabilize the patient in house. While discharging the patient the hospital must make sure that the patient who was sick coming into the hospital and is now no longer needing acute care services is still able to follow the plan set forth by the physician that saw them once they get home. If a patient had Cardiac Bypass surgery for example, they might need home health. Or if a patient has an infection requiring home IV antibiotics, does the patient have or will receive all the materials necessary to complete treatment at home.
Some patients have to go into a rehab facility. Documentation and communication are also a vital part in discharge planning. The chart must be documented appropriately to state why if any post-acute care is needed. The chart must include documentation on the plan that the patient needs or the facility needs for further care. Communicate with the patient and the family about the plan. Make sure to assess the patient and family’s level of understanding. One must be sensitive to patients that do not know medical terminology. Medications are a huge liability and a huge misunderstanding with patients. The plan must have medications clearly written with times and how often the patient should take them. The discharge nurse should take the time to verbally go over the medications with the patients and their family’s to ensure compliance with medications. In defining obligation for discharging the patient, the hospital has to consider many factors. Who decides when the patient is ready to go home? What services is the hospital obligated to provide? What should the patient be told and who should tell the patient?
Special needs must be taken into consideration before a patient is discharged. Make sure enough teaching is being provided. Assess a patient that is living on their own and might struggle with recovery, thus, needing possible home health or a rehab facility. Patient with inadequate financial resources of inadequate living facilities, need to be assessed for possible infection post hospital, and for medication compliance. Will the patient be able to afford any meds given at discharge? Are their free medication programs that this patient can be enrolled in? As a patient being in the hospital is usually not a vacation. The patient is sick, uncomfortable, can’t sleep well with machines going and IV lines, etc. Going home to a patient is truly the only thing that they care about. When a physician mentions the possibility of discharge to a patient, their only thought is freedom! It is vital to the patient that is not thinking of their health, for the discharge planner to go through the entire checklist to ensure that patients survival when they get out of “jail”.