EFFECTIVE DISCHARGE PLANNING

Effective Discharge Planning In An Acute Hospital

Effective Discharge Planning in an acute Hospital

Introduction

In many countries, attempts to curtail escalating costs of

acute inpatient care have resulted in pressures to reduce hospital length of stay (LOS) and transfer the responsibility for continuation of care to services in the community. Planning

hospital discharge has become an increasingly critical activity

that aims to achieve a smooth transition of patients to

continuing care serviceswherever possible, avoiding unnecessary

delays and discontinuities in their care while containing costs

and improving outcomes once the patient is at home (Caplan, 2004,

1423).

In most places, discharge planning has traditionally been

part of the social work domain; social workers work together with patients, families, and staff to develop specific discharge

plans to the home or to another institution. In the atmosphere

of cost-containment, social work research has also focused on

outcomes of discharge planning in terms of LOS and readmissions.

Other outcomes evaluated include satisfaction of patients and

families with services implemented postdischarge and their

adequacy in meeting patients' needs Less attention has been

paid to evaluating the process of discharge planning, that is,

clients' assessment of their involvement in the discharge

planning process during hospitalization, and their evaluation of

adequacy of those plans at the time of discharge. The purpose of

the current study was to examine the adequacy of discharge

plans developed for hospitalized patients and to expand the

understanding of factors related to the adequacy of these plans

as assessed by the patients or family. It is a part of a

comprehensive research examining continuity of care for

hospitalized patients seen by hospital social work services in

U.K. (Chiu, 2007, 336 ).

Literature Review

Discharge planning has been defined as ''a systematic, organized and centralized approach to providing continuity of care from the time a patient is admitted to a health care facility through return to the community'. In U.K., social workers do most of the discharge planning in acute care hospitals, screening for high-risk patients and intervening with those referred by staff members, particularly complex cases. Components of the process of discharge planning practice have been described and evaluated by social workers in various countries as well as in U.K.

These practice activities include (Counsell, 2006, 1141):

(a) early identification and assessment of patients likely to require services;

(b) coordinating the multidisciplinary health care team's discharge-related activities;

(c) identifying and coordinating resources necessary for posthospital care;

(d) providing information to patients and families to assist them in selecting and applying for services; and (e) follow-up of discharged patients.

Discharge planners' time is spent mainly on assessment and coordination, while follow-up is rarely a routine practice activity. Studies that examine how these activities are perceived by clients and family members are thus essential for providing feedback to social workers. Discharge planning is guided by social work practice principles and values. These values, as articulated in the Social Work Code of Ethics U.K., emphasize social workers' obligation to provide the clients with full information about available services, to ...