What Do Admission and Discharge Have in Common - Assignment Example

GP MANAGEMENT GP Management Admission and discharge share a lot similarities in that they are both significant for the patient’s well being. Just like admission, the efficiency of the hospital greatly depends on patient care at the time of discharge. If discharge is poorly managed, quality of patient care also falls and the more the chances of readmissions. Good discharge procedure ensures a lot of advantages including proper bed space management for emergency response, minimization of waiting time and patients stand more chances of post-hospital survival. GP manager are concerned with the task of improving and managing discharge among other tasks. There are a lot of similarities among the views of GP officers including identification and application of the proper discharge procedure, comprehensive quick diagnosis are required to be done for the patient within the shortest time possible after admission in order to determine how long the patient will take in the hospital. Screening is recommended to be done within the first 24hours unless the condition of the patient does not allow for such procedure. Screening is important since it gives jump start to patient treatment. In some situation, GP professional employ physiotherapy to maximize the value of screening. These procedures have not only added value to the quality of patient treatmen,t but also to the nature of discharge planning and communication. For the case of patient who are admitted for the purpose of defined treatment, their discharge can be planned right on admission or even before arrival. Application of pre-hospital admission is also handy in assessing discharge requirements that the patient may need at the time of discharge, their use have been widened by major hospitals. GP managers view on multi-disciplinary need in discharge GP officers believe that patients with complex medical needs the assistance of different specialists in order to achieve the highest quality if discharge. For instance, a woman with broken hips will need the services of a surgeon, orthopaedic and a nurse specialized in dealing with such injuries. The woman also needs rehabilitative care from specialist to help her recover more quickly and other health problems. An occupational specialist services are necessary to help the lady get back to her normal chores. However, it is sometimes impractical to have all these personnel working a coordinated fashion, the best remedy to use experience personnel to assist in discharge or to use someone who can handle the most tricky part of problem. In most case, specialists unknowingly find themselves involved in multi-disciplinary care, however, they cannot handle each procedure as it would have been handled by a trained personnel in a particular field. GP manager believe that developing integrated care training can go a long way in improving multi-disciplinary care at discharge. There are concern on when multi-disciplinary care should be used, in most case the cost is high and so it is only economical when used on patients with extreme health needs. Discharge documentation Discharge documentations are not mainly of administrative use, however, it is a means of communication between the different people who are involved in patient care to see the progress made and what remains to be done so the entire procedure is adequately harmonized. The patient records are in many cases spread among the individuals and may not be accessible to the other parties. GPs argue that these is best way to keep the records since placing all of them in one document may create access problems if different personnel need to access the information at the same time, the duplication and overlap of information is also minimized if patient records are kept separately by each professional group. However, if the records are kept in one neat and properly designed to enable the use by different professional then it can be the best way of aiding patient care services. In some cases, wards carrying patients with the same health needs have different records and so do the variation in discharge procedure, this may have an effect of lowering discharge services. Harmonizing records makes everyone’s responsibility to be clear and so the quality of discharge is raised. Delayed discharge In most cases delay in discharge do not result from the side of the hospital, but from arrangements with social work services, they may be failing to respond as required or may fail to make arrangements in time for the discharge. To avoid this, bodies providing such services should be informed early enough to enable them make assessments and arrangements for the discharge before the patients starts spending more time at the hospital despite the fact that he or she is fit for discharge. If information is not passed in time to the social service, then they are not the cause of the problem. If the assessment is begun late when the patient is almost ready for discharge, the process may not be complete by the time the patient should be discharged and some delay is inevitable. The effect of the delayed discharged should be measured in order for the responsible groups to make informed decisions so that a similar scenario is not experienced in the future. A number of recommendation need to be implemented to avoid delays in discharge such as: 1. Trusts should monitor delays by specialty and by reason. Reasons should be split in a way which will help identify where action is required, for example within the trust, other health services, social work or elsewherei. Within the broad groupings, specific problem areas should be monitored Trusts should agree definitions of delays and target times for assessment and placement with their local social work departments if they have not already done so. Definitions should be brought into line with national standard definitions once they are available. Data on delays should be agreed and shared with social work so that discussion can concentrate on solving the problems. ‘Same day delays’ such as transport and prescriptions should be monitored on at least a periodic basis. Monitoring should include the views of patients, carers and staff. Monitoring information should be used to identify where service development would be worthwhile to resolve particular problems. The views of patients and staff on the quality of the discharge process should be collected at least periodically as part of the monitoring process. Discharge information for GPs and Nurses Documents such as ‘the immediate discharge documents’ guideline has been introduced to improve quality of the information. When the letters produced by trust are compared to the Guidelines, few were found to compile completely. A number introduced immediate discharge document which complied with most of the guideline. To be discharged from hospital, nurses may first contact the patient. Timely information regarding patients discharge is therefore very important for district and practicing nurses. The time of discharge from hospital is therefore necessary for the GP to provide appropriate care. Discharge letters issued to patients are usually used to achieve this Providing information to patients and careers During discharge, patients and their cares require clear and comprehensive information about follow up treatment services. Trust is the major determinant of information provided to patients. Though patients might receive inconsistent messages from medical staff, they consider verbal communication with patient as good. Where nursing and PAM staff multi-disciplinary working was less developed, information should be provided in writing . This is for patients to refer at their own time. Most written communication does not cater for any queries that the patient might have. Trust discharge policy and inter-agency agreements and arrangements While moving from acute care of the community, staff should work together to provide a seamless service through the joint discharge agreements . The agreement provides and a combination of more detailed protocols establishes the kinds of information to be shared and how duplication can be avoided in the assessment process. Management Executive Letter, which is the governing body of Hospital discharge arrangements, makes clear outline of the joint responsibility whish leas with health bodies and authorities. The arrangement provides for clear outline of the responsibility of the varying groups of staff. It monitors the quality of service, discharge process and the agreed aims of the institution. These are used as performance measures and should be stated in terms of the process, targets and standards. Actions that should be taken to rectify delays and care should be clearly stated. Read More