PFC 2005 - Discharge hospitals community/home

Page contents: Aim | Change Concepts | Key Change Principles | Measures | Resources | Toolkits | Training | Websites and links

Aim

To provide effective discharge of patients to community/home setting.

Change Concepts

• Implement standardised discharge policy and documents
• Plan discharge as soon as possible in the process, i.e. GP, out patient department, emergency department
• Final preparation of patients for discharge days before their planned discharge
• Establish seamless system to provide all information and medications to patient and general practitioner
• Identify daily patients who have a delayed discharge with action plan
• Incorporate Transport, external services in process plan as soon as possible, which will provide more flexibility in all providers' planning.

Key Change Principles

• Plan pull system that prepares the patient for next stage when in advance.

Measures

Program Measures

• Average Admissions & Discharges by day of week (Bar chart)

Case Study Measures

• Discharges by time of day

HDM Monitoring

• Provides complete monitoring of health services for monthly/quarterly and 6-monthly KPI/KRA performance, with comparisons to targets (where applicable) and the previous year
• Includes a mixture of provisional data provided by health services and data from ESIS/VEMD/VAED
• Encompasses ED processes, Elective Surgery Services, ICU/CCU, Patient Flow and Exit Block indicators
• VAED Indicators:
  • Acute Patients with LOS > 14 Days at EOM
  • Interim Care Patients at EOM
  • Average LOS in Interim Care - Pilot Site
  • Average LOS in Subacute care (days) - REHAB 2
  • Average LOS in Subacute care (days) - GEM

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Resources

Patient Care Between Hospital and Community (59kb, pdf)

Toolkits

• Single assessment

Training

• Process mapping
• Consumer involvement
• Whole system

Websites and Links

NHS UK - Discharge from hospital - good practice guide

Commission for Health Improvement - Emergency readmission to hospital following discharge for children

Commission for Health Improvement - Emergency readmission to hospital following discharge

Brigham and Womens Hospital UK - Performance Improvement

Department of Human Services - Effective Dischare Strategy

CFMC USA - Hospital Quality Improvement Projects

Brown-Spath & Associates - Is Your Discharge Planning Effective?

Press Ganey - The Satisfaction Monitor

National Audit Office UK - Ensuring the effective discharge of older patients from NHS acute hospitals

The Cochrane Library - Discharge planning from hospital to home

National Cardiovascular Disease Programs: Secondary Prevention (954kb , MS Powerpoint)

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