Discharge planning – or more precisely, the lack of it – was a predominant conversation at the Chief Nursing Officer Summit we attended last month in Scottsdale, Arizona.
At a time in which hospitals say they are upping their focus on patient-centered care, how is it that nearly half of hospital patients - 48% - still don’t understand their discharge instructions? Those were the statistics shared from the podium.
Many factors contribute to answering that question. Hospitals are caring for an increasingly diverse patient population. With that comes greater language and cultural barriers that can impede health literacy. Patients tend to be sicker. Average length of stay is shorter – compacting the time nurses have to educate them. Nurses have never been busier, and nursing shortages and high nurse turnover rates place a greater demand on the workforce. At the same time, nurses are being asked to take on more tasks outside of bedside patient care.
Planning for Discharge Starts at Admission
Discharge planning – the process of preparing a patient for their care once they leave the hospital – starts from the time the patient is admitted. “One of the most important duties nurses have is to prepare patients for discharge,” says Carole Jakucs, BSN, RN, PHN, in a recent Nurse.com blog. “Teaching patients about their conditions, medications, self-care strategies, and the importance of follow-up care can help patients maintain an optimum level of health and reduce their chances of readmission to the hospital.”
Include the patient and family as full partners in the discharge planning process.
Discuss with the patient and family the key areas to prevent problems at home, including reviewing medications and explaining test results.
Educate the patient and family in plain language about the patient’s condition, the discharge process, and next steps at every opportunity throughout the hospital stay.
Assess how well doctors and nurses explain the diagnosis, condition, and next steps in the patient’s care to the patient and family and use teach back.
Listen to and honor the patient and family’s goals, preferences, observations, and concerns.
Using Technology for Better Discharge Planning
The best technologies are those that help humans do things better, faster, and more effectively. But when one presenter at the CNO Summit last month asked for a show of hands – how many CNOs’ hospitals employ patient engagement technology to improve discharge readiness? – only a scant few hands were raised.
That is a missed opportunity.
Hospitals who are employing Allen E3 patient engagement technology are pointing out notable outcomes and improvements.
Hospitals using the Allen Technologies E3 patient engagement solution, far outpaced others on CMS discharge readiness score improvements, over six years of HCAHPS reporting. Collectively, Allen hospitals have improved discharge readiness HCAHPS ratings by 3.57% during that time - far ahead of the national average of 2.35%.
Beyond that, Allen customers saw a 5.00% improvement in medication communication HCAHPS ratings, something the AHRQ says is a key component of discharge planning. That is nearly two full percentage points greater improvement than hospitals as a whole.
In addition, nurses who use Allen’s E3 interactive patient engagement solution for patient education teach-back are achieving significantly higher nurse communication scores. With it, nurses can assign health education videos specific to the patient’s diagnosis. Then, when rounding, they can use their bedside time to reinforce the information and address any questions. Collectively, Allen’s customers have seen those ratings improve 5.41% from the outset of HCAHPS reporting in 2012 to the most recent 2018 data. Nationally, hospitals only improved by 2.56%.
Completing the Process: A Patient Discharge Checklist
A patient discharge checklist is the final critical step to ensuring the patient is fully prepared to leave the hospital. Interactive checklist screens on the patient room TV, touchscreen monitor and/or tablet gives the nurse, patient, and family an easy and visual way to walk through each task.
- Does the patient understand all the medications that he or she will be taking? (The Allen E3 interface even allows the patient to order their medication from the hospital pharmacy.)
- Has the patient viewed all the education videos, and are there any areas that need further explanation?
- What about transportation home and to doctor appointments later?
- Is it clear what the care plan is for daily activity, medications, diet, therapy, or doctor appointments, and what symptoms should trigger a call to the hospital?
Using an E3 checklist, the nurse doesn’t have to recall each of these steps or remember the outstanding to-do items for each patient. The system’s on-screen prompts automate that process, making it both more efficient and more effective.
At Allen, we believe that improving discharge readiness doesn’t have to be hard. Our interactive technology is proving to be a game-changer in helping nurses educate and prepare patients for discharge - better, faster, and more effectively. Our human-centered solutions are easy for the nurse to use and easy for the patient to interact with. The HCAHPS results speak for themselves.
Learn how Allen can help transform your hospital experience. Visit us at www.EngageWithAllen.com.