18 September 2015

Coordinated Hospital Discharge Essential for Quality Care

Delayed and uncoordinated hospital discharges were two key findings highlighted recently by Healthwatch England following an investigation into common problems experienced by patients during and after the hospital discharge process. The feedback gathered from patients was categorised into five core issues, including a lack of coordination between services, feelings of being left unsupported and excluded from the decision-making process.

Participants in a recent #NurChat discussion echoed these findings in their experience, adding that patient hospital discharges are sometimes delayed by access to medication and or even transport arrangements. A delayed discharge can mean a person deemed healthy enough to return home is held up in hospital by the administration process, which impacts upon their wellbeing, their family and ultimately the cost of their hospital stay.

Simple, effective planning that involves each team from the moment a patient is admitted to hospital can help reduce any delays that occur through coordinating services and staff. However, when it comes to a patient navigating the complex network of support services and care team, it can seem daunting if unsupported. A single point of contact, such as a Discharge Liaison Nurse, who can effectively communicate between all parties can help alleviate any confusion.

Suitably trained staff with the skills to support an individual who has complex needs can be a significant factor in whether a hospital discharge back to the community can go ahead on time. Some #NurChatters highlighted that staff can only access training following a continuing healthcare assessment of the patient, which can mean days or weeks before their care needs can be met outside hospital.

The role of the Healthcare Assistant and how much of the nursing skill base could or should be delegated was also discussed. The role of Advanced Practitioner could be used to coordinate discharge plans, however 1 participant found that that their staff member in this position swiftly moved on to undertake nursing training once they achieved their new skills. Another possible role was a specific discharge co-ordinator, with similar expertise of the AP, however this could be a return to a role that previously used to exist in many hospitals before it was axed some time ago.

Technology could play a more significant role in the discharge process, with remote monitoring and automated warnings alerting a care team to any deterioration in a patient’s health once they leave the hospital environment. Some instances of video calling used to liaise with patients and manage any ongoing health issues have been shown to be successful, but it could be some time before real-time remote monitoring is a reality.

Come along to the next #NurChat discussion on 29 September 2015 at 8pm when we’ll be welcoming new student nurses to the community and helping them find out how to use Twitter to get relevant support from current students and qualified nurses alike.