Discharging patients from acute care is a challenge for many organizations. The costs are high, the turnaround times are long, and there is often a stigma around these patients.
To understand the challenges of navigating this transition, we performed a systematic review to identify and synthesize evidence about discharge interventions for adults receiving acute mental health care. Our findings showed that most of these interventions focused on reducing readmission, improving well-being, facilitating treatment adherence, and accelerating discharge.
Contents
Patient Safety
Like in Sam Lee Prospect Medical, patient safety is essential to any healthcare provider’s mission. It can help reduce preventable injuries and infections, improve treatment outcomes, and lower hospital readmission rates.
A safe discharge requires a comprehensive approach to safety that addresses every aspect of patient care, including adherence, communication, and patient education. It also involves ensuring that all healthcare professionals are appropriately trained and qualified.
The literature on hospital discharge indicates that the transition from acute hospital to community care is a vulnerable stage in the care pathway. This is mainly due to the challenges of coordination and collaboration among health and social care agencies.
Patient Adherence
Discharge from acute care can have significant adverse outcomes for patients. These include unnecessary hospitalization, ER visits, and delays in receiving follow-up services in the community.
To ensure that patients receive appropriate and timely care, healthcare companies need to understand the challenges of adherence when discharged from acute care. This requires a 360-degree approach to patient behavior incorporating individual and demographic factors and behavioral and social drivers of non-adherence.
Patients are more likely to adhere when they understand medical recommendations, have good physician-patient relationships, and feel that the treatment environment supports their behaviors. Despite these positive drivers, there still needs to be more adherence. Identifying the drivers of non-adherence and developing effective interventions are two critical steps in improving compliance.
Communication
The discharge process can be challenging, especially when patients are complex or have long-term care needs. It requires parallel, coordinated activity from various healthcare providers, patients, and their families.
The fragmentation of healthcare services and poor communication between healthcare professionals can exacerbate this. However, improving this is a vital step in the overall success of discharge planning.
A qualitative study involving staff from an acute care medical teaching unit found that the key barriers to discharge were communication, role clarity, and lack of resources. These could be addressed through electronic discharge summaries and bullet rounds, the appointment of a discharge coordinator or liaison, and the involvement of families.
Patient Education
When discharged from acute care, patients need education about self-managing their condition at home. For example, if a patient has undergone surgery, they need to know how to handle wounds at home to prevent infection and readmissions.
Providing patients with health education that’s understandable and actionable can help reduce anxiety and confusion, allowing them to self-care more effectively. It can also educate hired or family caregivers about how to assist with at-home care management and give them tips on communicating with providers.
Hospitals must ensure the discharge process is smooth for all parties involved – patients, their families, and care providers. This includes multidisciplinary collaboration, communication, and coordination from admission through discharge.
Family Support
They often need to rely on family or friends for help when discharged from acute care. This can include help with transportation, meals, counseling, and support groups.
In addition, patients may have special needs that require additional care or support during their recovery. For example, they might need assistance with bathing or medication administration.
Many interventions have been developed to address the challenges of the care transition. These vary in approach, with some focusing on specific areas such as reducing homelessness or improving treatment adherence and others looking at the broader problem of coordinating care across different agencies.
