Discharge Planning from Hospital to Home

Question: Summarise a journal article which takes into account the role of the Australian Registered Nurse in the discharge planning process. Briefly outline how discharge planning in the acute care setting may maximise health and minimise costs. Answer: Shepperd S, McClaran J, Phillips CO, Lannin NA, Clemson LM, McCluskey A, Cameron ID, Barras SL., 2010, Discharge planning from hospital to home (Review), The Cochrane Library, No.1. In this review article, Shepperd et al. have investigated the effect of proper discharge planning by conducing and comparing through randomized controlled trials. The study concluded that the impact of proper discharge planning was positive on the length of stay in the hospital, the readmission rates of the older people. However, the study could not ascertain the impact of proper discharge on the mortality rate, health outcomes and the total cost. Barnes, D., Palmer, R., Kresevic, D., Fortinsky, R., Kowal, J., Chren, M. and Landefeld, C., 2012, Acute Care For Elders Units Produced Shorter Hospital Stays At Lower Cost While Maintaining Patients Functional Status, Health Aff, Vol. 31, no. 6, pp: 1227-1236. In this research article, Barnes et al. have concluded that after having conducted randomized control trials on the elderly people, it has been found that the length of stay in the hospital was shorter for the patients who were receiving acute care as compared to the length of stay of the patients who received usual care. Moreover, the proper discharge set up also helped in lowering the total inpatient cost, maintaining the patients functional abilities and even leading to the reduction in the readmission rates into the hospital. The inclusion of the practices of Acute Care for Elder Units have proved beneficial for the hospitals by providing them effective strategies low reducing the cost while simultaneously preserving the quality of care being delivered. Konetzka, R., 2007, Reducing hospitalizations from Long-term care settings, Med. Care Res Rev., Vol. 65, no. 1, pp: 40-66. Konetzka has demonstrated the importance of certain interventions that can help in relieving the stressful process of hospital stay and the continued and ongoing treatment. This articles reviews the evidence that is collected from 55 peer reviewed articles and the conclusion that can be drawn from the study is that that strongest and the most effective are those implementations like skilled staffing (inclusion of physician and nurse practitioners in the tea), improvisation of the hospital to home transition by ensuring proper and organized discharge, substitution of the home health care for selected hospital admissions and alignment of the reimbursement policies such that the providers do not have financial incentive to hospitalize. Stone, J. and Hoffman, G., 2010, Medicare Hospital Readmissions: Issues, Policy options and PPACA, Congressional Research Service. Stone, J and Hoffman, G. presented a paper cum report describing the efficacy of some service delivery and financial reforming programs and strategies that had the potential to improve the quality of care being administered to the elderly people who were suffering from some or the other chronic disease. They stressed on the type of care provided to the patients who are transferred from hospitals to home, while they reside in their homes, keeping in consideration the community based, long term and medicare post acute based care of the patients.