Discharge Planning

What is Discharge Planning ?

Medicare says discharge planning is "A process used to decide what a patient needs for a smooth move from one level of care to another."

In general, the basics of a discharge plan are:• Discussion with the patient or his

representative• Planning for homecoming or transfer to

another care facility• Determining if caregiver training or other

support is needed• Referrals to home care agency and/or

appropriate support organizations in the community.

DISCUSSIONAt the very outset of discharge planning, health care

professionals, family caregivers, and the patient (if appropriate) should discuss the following:

• The patient’s condition, and any changes• Any likely symptoms, problems, or changes • The potential impact of caregiving on the caregiver;

PLANNINGPrior to discharge, health care

professionals should work with family caregivers – with patient consent, if appropriate – to: 1. Arrange for an in-hospital assessment

to determine Medicare2. Set up home care services for which

the patient 3. Get the home ready by arranging for

equipment rental and home modification;

4. Provide a 24-hour phone number the caregiver

5. Organize transportation home for the patient;

6. Schedule a follow-up appointment.

TRAININGBefore discharge, health care professionals should

provide family caregivers with applicable training, including:

1. A written medication list with specific instructions2. Teaching and practice of techniques

REFERRALSBefore discharge, health care

professionals, caregivers, and patients should explore available support services, including:• Community sources of social support;• Community-based agencies that

provide services such;• Information resources such as books,

pamphlets, videos, and websites.

Why is good discharge planning so important?

Effective discharge planning can decrease the chances that your relative is readmitted to the hospital, help in recovery, ensure medications are prescribed and given correctly, and adequately prepare you to take over your loved one's care.

The caregiver's role in the discharge process :

• The discharge planners should discuss with you your willingness and ability to provide care.

• It is essential that you get any training you need in special care techniques, such as wound, feeding tube or catheter care, procedures for a ventilator, or transferring someone from bed to chair.

Getting help at homeListed below are common care responsibilities you may be handling for your family member after he or she returns home:

• Personal care: • Household care: • Healthcare: • Emotional care: • Community organizations can help with services

CASE• On Saturday night Mr. C hospitalisation with

diagnosis fracture penis in hospital since a week ago. The patient’s condition had already improved and allowed to go home.

THANK YOU