There is a saying that the last impression you make is the lasting one. Put another way, it means that your wonderful meal can be ruined by having to wait 20 minutes for your check to arrive. Since that is the case, healthcare providers should spend more time and energy improving their discharge experiences.
Over the past year, I there has been a lot of focus on the front-end patient experience. At many of the conferences I have attended, presenters have highlighted how they have:
- Made it easier for patients to find and book appointments online
- Implemented new chatbot technology (usually AI-powered) to help patients more easily navigate their website to find a specialist, book an appointment, determine whether or not they should come into the ER
- Improved their waiting areas or eliminated them altogether by asking patients to safely in their cars
- Added more contact center agents
- Installed better wayfinding
In contrast, there has not been as much attention placed on the experience AFTER the appointment/procedure.
Financial Experience
In fairness, there has been attention placed on the overall financial experience of patients. I have seen a few sessions and a number of vendors that are championing better payment technologies + process for patients. There is recognition that receiving a confusing or inaccurate medical bill is one of the biggest complaints from patients.
Improvements in this area include:
- Online payment options
- Multiple payment options (credit card, paypal, check, direct transfer)
- Payment plans
- Connecting patients with financial assistance programs
Discharge Experience is Lacking
However, there is not much talk or movement on the other aspects of discharge process. I still hear horror stories of patients waiting for hours in hallways to be discharged or of patients having to wait in the inbound waiting room as transportation is arranged.
There is a lot of “to dos” that need to be completed as part of discharging a patient including:
- Reviewing medications
- Discussing at-home care with patient/caregiver
- Arranging any home care
- Scheduling follow up appointments
- Providing educational materials to the patient
- Answering questions from patient/caregiver
- Providing the devices for patients to be safely monitored at home
…plus much more.
The AHRQ has a helpful checklist for the ideal patient discharge.
In a paper published in 2021, the authors has this to say about the importance of discharge planning: Patients who do not have enough information about their discharge plans have decreased treatment compliance, decreased patient safety, increased emergency department (ED) recidivism, and poor satisfaction. Baseline observations found that written discharge instructions were long and tedious, and important information was difficult to find.
Discharge Discussion
On the next weekly HCLDR tweetchat – Tuesday March 21st at 8:30pm ET (for your local time click here), I thought it would be interesting to interesting to discuss the discharge process – specifically how it can be improved and what the ideal looks like.
- Q1 What aspect of the patient discharge process needs the most improvement?
- Q2 What does your ideal patient discharge experience include?
- Q3 How can healthcare organizations get patients and their caregivers more involved in the discharge process?
- Q4 Are more regulations or incentives needed to significantly improve the safety, thoroughness, and general satisfaction with/of the discharge process?
References
DeSai C, Janowiak K, Secheli B, et al. “Empowering patients: simplifying discharge instructions”, BMJ Open Quality, 14 September 2021, https://bmjopenquality.bmj.com/content/10/3/e001419, accessed 19 March 2023
Krook M, Iwarzon M, Siouta E. “The Discharge Process-From a Patient’s Perspective”, SAGE Open Nursing, 20 January 2020, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7774357/, accessed 19 March 2023
“IDEAL Discharge Planning Overview, Process, and Checklist”, AHRQ, https://www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/engagingfamilies/strategy4/Strat4_Tool_1_IDEAL_chklst_508.pdf, accessed 19 March 2023
“Poor discharge practice leading to ‘unnecessary patient suffering”, National Institute for Health and Care Excellence, 21 July 2015, https://www.nice.org.uk/news/article/poor-discharge-practice-leading-to-unnecessary-patient-suffering, accessed 19 March 2023
Jones B, James P, Vijayasiri G, et al. « Patient Perspectives on Care Transitions From Hospital to Home”, JAMA Network Open, 6 May 2022, https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2791965, accessed 19 March 2023
“Hospital discharge planning hinges on good communication”, Healthy Debate, 6 June 2017, https://healthydebate.ca/2017/06/topic/hospital-discharge-planning/, accessed 19 March 2023
Minemyer, Paige. “The biggest discharge planning hazards faced by hospitals”, Fierce Healthcare, 9 January 2019, https://www.fiercehealthcare.com/hospitals-health-systems/biggest-discharge-planning-hazards-faced-by-hospitals, accessed 19 March 2023
Image Credit
Photo by cottonbro studio: https://www.pexels.com/photo/a-doctor-talking-the-patient-7579831/
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