Providing patient-centered enhanced discharge planning and rural transition support: Verifying discharge orders during rural transitions

Abstract

Patients typically leave a hospital with numerous tasks that need to be performed in order to complete their treatment successfully. The discharge process is designed, in part, to describe the services a patient needs to secure or the tasks they need to perform in order to complete treatment and promote recovery once he or she gets home. Many of the orders or services planned should be implemented immediately or soon after discharge to be useful. Some involve additional medical treatment. Others may involve starting long-term services that address chronic conditions. In this delicate transition, hospital staff may not convey the orders clearly or may not complete tasks. A patient preparing to leave the hospital may have limited time to follow the description or not be responsive to the staff. The patient may simply forget the information provided or misunderstand it. Written information may be difficult to read (e.g., small print, dense wording). Similarly, providers referenced in the plan may misunderstand, misinterpret, or simply forget. Accordingly, there is a need for methods to increase the likelihood that these orders are filled and needed treatments are completed. One approach is to monitor the implementation of these components of a discharge plan. This document is a brief practice guide outlining an early step in providing rural transition support, the verification of discharge orders

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