Pre-hospital discharge planning: empowering elderly patients through choice.
Reductions in the length of stay for acute hospitalization have occurred as a result of Medicare cost containment strategies during the past 20 years. Thus, innovative approaches to the treatment of patients in the acute care hospital setting are necessary, particularly in the practice of discharge planning. The medical literature typically identifies the first day of admission as the time to begin discharge planning in order to minimize the patient's length of stay in the acute care hospital. This strategy has its limitations as elderly patients are often confused by unfamiliar surroundings, surgical anesthesia, postoperative pain, and the rapid pace of hospital recovery typically expected today. Consequently, options for discharge may be limited to the most expedient plan that will ensure safety and continued recovery. This article presents an alternative plan that begins with outpatient education preceding admission and follows the patient throughout the continuum of care including postdischarge.
Merriman
Mary L
ML
Care Coordination Department, Penn State Hershey Medical Center, Hershey, PA 17033, USA. mmerriman@psu.edu
D000046:Academic Medical Centers / Q000458:organization & administration; D000203:Activities of Daily Living; D000208:Acute Disease / Q000523:psychology / Q000628:therapy; D000368:Aged / Q000523:psychology; D002755:Choice Behavior; D003266:Continuity of Patient Care / Q000458:organization & administration; D003363:Cost Control; D019091:Critical Pathways / Q000458:organization & administration*; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D007902:Length of Stay; D020380:Needs Assessment; D009730:Nursing Assessment; D010347:Patient Care Planning / Q000458:organization & administration*; D010351:Patient Discharge; D010353:Patient Education as Topic / Q000458:organization & administration; D010358:Patient Participation / Q000379:methods / Q000523:psychology; D010414:Pennsylvania; D011209:Power, Psychological; D012947:Social Work / Q000458:organization & administration; D019467:Subacute Care / Q000458:organization & administration