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Monday, August 11, 2014
  Clinical Accuracy Spoken Here  

Discharge Planning:
Clarity of Instructions

It has been estimated that 66% of preventable medication errors occur during transitions in care and 12% during discharge.

One study indicated that most hospital discharges (71.2%) had at least one type of reconciliation problem and frequently involved a high-risk medication (76.6%).

More attention needs to be given to the quality of discharge instructions, and the problem of vague phrases such as "take as directed" can be addressed by adding it to "do not use" lists to promote safer transitions in care.

[Reference: Discharge Planning, Module B, Patient-centered DP]
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  Excellence in Case Mgmt  

Discharge Planning:
Non-Coverage Issues

It may fall to the discharge planner to notify the patient about the insurer's decision, make sure the patient receives a HINN (Hospital-Issued Notices of Non-coverage), and advocate on behalf of the patient with the insurer to reverse the "denied days" decision.

Hospitals provide Hospital-Issued Notices of Non-coverage (HINNs) to beneficiaries prior to admission, at admission, or at any point during an inpatient stay if the hospital determines that the care the beneficiary is receiving, or is about to receive, is not covered.

[Reference: Discharge Planning, Module A, Philosophy and Standards]
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  Improving Patient Care...  

Discharge Planning: Strategies

Conducting bedside rounds with the team is a good planning strategy, as all of the team members can interface with the patient at the same time. They benefit from being able to ask the patient questions from their different perspectives with the rest of the team members present.

As technology evolves "virtual" rounds via closed circuit TV are becoming more common. Team members can participate from remote locations.

In order to prevent a possible extended length of stay (LOS) due to miscommunication or lack of information, communicating regularly with all team members and keeping them informed is imperative.

[Reference: Discharge Planning, Module B, Patient-centered DP]
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Tom RasmussenTom Rasmussen
Publisher
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