Discharge Planning 101 (Part 1): How to Safely Discharge a Patient from the Hospital

Step-by-Step Tutorial: How to Safely Discharge a Patient from the Hospital

Part 1: Understanding the Key Considerations for Discharge Planning

1. Introduction to Discharge Planning

   • Discharge planning is crucial for ensuring a safe transition out of the hospital for patients.
   • It involves taking all necessary steps to prepare the patient for discharge, involving a multidisciplinary team.

2. Understanding Skilled Needs

   • Skilled needs refer to services that can only be provided by licensed professionals like nurses, physical therapists, or occupational therapists.
   • Examples of skilled needs include IV medications, tube feeds, wound care, and physical therapy.
   • Skilled needs help determine where a patient can go after discharge, such as a rehab facility or a Skilled Nursing Facility.

3. Determining Discharge Destination

   • The discharge destination is where the patient will go after leaving the hospital.
   • Consider factors like the patient's skilled needs to determine the recommended discharge destination, which can include home health, rehab facilities, or acute care units.

4. Identifying DME Needs

   • DME stands for durable medical equipment, including items like canes, walkers, wheelchairs, and nebulizers.
   • Assess the patient's DME needs and arrange for equipment early to ensure a smooth transition post-discharge.

5. Managing Medications

   • Some medications may require prior authorization from insurance companies before they can be dispensed.
   • Keep track of medications needing prior authorization and ensure the necessary paperwork is completed to avoid delays in obtaining medications post-discharge.

6. Scheduling Follow-Up Appointments

   • Every patient will need at least one follow-up appointment, typically with their primary care doctor.
   • Schedule follow-up appointments with specialists in advance to ensure continuity of care post-discharge.

7. Preparing for Dialysis

   • If a patient requires dialysis post-discharge, work with a case manager to set up appointments and necessary lab tests.
   • Ensure labs are done ahead of time to facilitate a smooth transition to outpatient dialysis centers.

8. Assessing Caregiving Needs

   • Determine the level of caregiving and supervision the patient will require post-discharge, especially if they live alone.
   • Differentiate between home health services and hiring a caregiver, as they serve different purposes.

9. Addressing Language Barriers

   • Consider language barriers and health literacy levels when providing patient education.
   • Use interpreters and involve family members or friends who can assist in ensuring the patient understands post-discharge instructions.

10. Removing Tubes, Drains, and Lines

    • Ensure all unnecessary tubes, drains, and lines are removed before discharge to avoid complications.
    • Keep track of these items in progress notes and remove them as soon as they are no longer needed.

11. Arranging Transportation

    • Confirm that the patient has a ride home arranged, whether it's a family member, Uber, or public transportation.
    • Coordinate transportation services in advance to prevent delays on the day of discharge.

12. Stay Organized and Plan Ahead

    • Keep detailed notes, track all considerations, and plan ahead to ensure a smooth discharge process.
    • Watch Part 2 of the video for additional tips on managing the discharge process effectively.

By following these steps and considerations, healthcare professionals can effectively plan and execute safe patient discharges from the hospital, ensuring continuity of care and patient well-being.