Barriers to discharge from inpatient rehabilitation: a teamwork approach

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 amon...

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Bibliographic Details
Published in:	International journal of health care quality assurance Vol. 30; no. 2; pp. 137 - 147
Main Authors:	Cruz, Lisanne Catherine, Fine, Jeffrey S., Nori, Subhadra
Format:	Journal Article
Language:	English
Published:	England Emerald Publishing Limited 13-03-2017 Emerald Group Publishing Limited
Subjects:	Arthritis Certificates Collaboration Communication Community resources Community support Coordination Cost control Critical incidents Discharge Discharge planning Drugs Health administration Health care policy Health education Hospitalization Hospitals Humans Inpatients Interprofessional Relations Intervention Leadership Length of stay Medicaid Medical errors Medicare Nurses Nursing care Occupational therapy Patient Care Team - organization & administration Patient Care Team - standards Patient Discharge - standards Patient education Patient Safety Patient Satisfaction Patients Population Psychology Quality Improvement - organization & administration Quality Improvement - standards Quality of care Readmission Reconciliation Rehabilitation Rehabilitation Centers - organization & administration Rehabilitation Centers - standards Safety measures Savings Social work Stroke Teamwork Trauma Trauma centers Traumatic brain injury Visibility Wheelchairs United States > US Leadership Continuous quality improvement Patient safety Discharge barriers Health and safety Patient satisfaction Length of stay
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Summary:	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.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0952-6862 1758-6542
DOI:	10.1108/IJHCQA-07-2016-0102