Improving guidance to patients, family caregivers on care facilities
Monday, May 13, 2019
Family caregivers and patients struggle with choosing quality care facilities. This includes both those who have not yet been hospitalized and those who are being discharged to a lower level of care.
Unfortunately, sometimes they find their choice isn’t the best fit or safety concerns arise. Delays in choosing a facility increase the risk of discharge for hospitalized patients. Choosing the wrong facility can also strain resources with an unnecessary hospitalization or re-hospitalization.
A recent Kaiser Health News article addresses the need for smarter decisions on where to recover after a hospitalization, starting with better guidance from hospitals themselves.
"Discharge planning begins on admission" is a common refrain in hospital meeting rooms. But, is it effective in practice? Are patients and their family caregivers engaged in a meaningful way upon admission?
Hospital leaders must ask themselves if patients are provided information that helps them understand their needs, and act — choosing higher quality facilities. For example, the Kaiser Health article references the common practice of giving patients a list of nearby facilities.
In this world of data-driven decisions and high reliability, is this enough? Or should the list include quality, safety and satisfaction ratings — either determined internally, externally, or both?
The age of healthcare transparency, especially for quality, safety and cost, has brought about a variety of online research tools. In addition to hospitals, Medicare.gov offers comparison tools for nursing homes, home health services, dialysis facilities, long-term care hospitals, rehabilitation facilities, hospice, and more.
Some state facility licensing agencies also offer their own comparison tools for consumers and providers. At a minimum, lists of facilities offered should include links to comparison tools that are relevant to each patient’s needs. Providing this information electronically will make it easy for patients and their family caregivers to find the information they need for more informed decisions.
Hospitals and other providers are concerned about their liability when specifying referral facilities, but there is also risk and liability to having a patient transferred to the wrong facility. This includes poor satisfaction ratings with the discharge process, the risk of readmission and potential liability for patients transferred to a facility that is known to be ill-equipped to meet their needs.
A healthcare delivery system that is truly patient-centered will find ways to leverage existing data to improve the discharge process and hand-offs to other levels of care. Taking on this opportunity for improvement — providing patients and family caregivers with more useful information — will not only benefit patients, but also care facilities in the community.
The same data and information provided to patients and family caregivers can also be used by leaders in the local network of care to improve their own performance on indicators of quality, safety and satisfaction.
At the end of the day, a more robust hospital discharge planning process that includes the information patients need to make more effective and efficient decisions can benefit the entire healthcare delivery system and its community with better patient outcomes.
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