title: Barriers to discharge from inpatient rehabilitation: a teamwork approach.
abstract: Purpose In order to prevent adverse events during the discharge process, coordinating appropriate community resources, medication reconciliation, and patient education needs to be implemented before the patient leaves the hospital. This coordination requires communication and effective teamwork amongst staff members. In order to address these concerns, the purpose of this paper is to incorporate the TeamSTEPPS principles to develop a discharge plan that would best meet the needs of the patients as they return to the community. Design/methodology/approach Through a gap analysis, barriers to discharge were identified from the following disciplines: nursing, social work, physical and occupational therapy, psychology, and rehabilitation physician. To improve communication, weekly meetings and twice-weekly huddles were implemented so that concerns regarding discharge obstacles could be identified and resolved. Visibility of discharge dates were improved by use of graduation certificates in patient rooms and green ribbons on patient wheelchairs. Findings After implementation of this discharge intervention, length of stay was reduced providing cost savings to the hospital, patient satisfaction on HCAHP surveys improved and demonstrated patient satisfaction with the discharge process, and readmission rates improved. Originality/value This study demonstrated that effective teamwork and communication can improve patient safety and satisfaction during the discharge period.
authors.affiliation: Rehabilitation Medicine, Elmhurst Hospital Center, Elmhurst, New York, USA.
authors.forename: Lisanne Catherine
authors.initials: LC
authors.lastname: Cruz
authors.affiliation: Rehabilitation Medicine, Elmhurst Hospital Center, Elmhurst, New York, USA.
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Fine
authors.affiliation: Rehabilitation Medicine, Elmhurst Hospital Center, Elmhurst, New York, USA.
authors.forename: Subhadra
authors.initials: S
authors.lastname: Nori
mesh_terms: D003142:Communication; D006801:Humans; D007297:Inpatients; D007400:Interprofessional Relations; D010348:Patient Care Team / Q000458:organization & administration* / Q000592:standards; D010351:Patient Discharge / Q000592:standards*; D061214:Patient Safety; D017060:Patient Satisfaction; D058996:Quality Improvement / Q000458:organization & administration* / Q000592:standards; D012047:Rehabilitation Centers / Q000458:organization & administration* / Q000592:standards
keywords: Continuous quality improvement; Discharge barriers; Health and safety; Leadership; Length of stay; Patient safety; Patient satisfaction