Prepare Patients for Timely Discharges
- Have early discussions of discharge plans with patients and family members to set appropriate expectations.
- Inform patients regarding discharges before placing a discharge order so the nurse is not the first one to inform them of the discharge.
- Enter discharge orders early as opposed to at the end of the day.
- Coordinate care with consultants and clear patient discharges with all consultants before placing the discharge order.
- Consultants should communicate clearly with the patient that if they clear the patient for discharge, the patient must still wait for the attending provider to write the discharge order before they can leave.
Upon Admission
- Review and order all PTA meds. Some meds are non-formulary and need to be entered, while some meds are not being reordered when they need to be.
- If a med from home is not being restarted, be sure to explain to the patient why the med is not being restarted.
Establishing Plan of Care
- Round on patients early in the morning so you can inform the multidisciplinary team of the plan before MDR rounds.
- Hospitalists and consultants should focus on providing clear communication to one another regarding a patient’s plan of care. Communicate clearly to one another and document clearly in your notes.
- Consultants planning to initiate a new medication or dosage, perform a procedure or clear a patient for discharge should enter all of these orders and notes in Epic. Consultants should focus on being responsive to hospitalists’ queries to ensure all providers are aware of the patient’s plan of care.
Orders
- You must enter your orders directly in Epic.
- Nursing staff don’t accept verbal orders unless in an emergency situation with the patient.
Communication
- Use PerfectServe. Be sure to respond to your colleagues within 30-45 minutes to avoid repeat communication, especially for time sensitive matters.
- Use inpatient free texting to keep family members informed of patient progress. This reduces additional phone calls from family members and promotes higher patient satisfaction with their stay.
- Keep patients/families informed of new treatments, procedures, the overall discharge plan, etc. Nurses should not be the first person to inform patients/families of their care and discharge plans.
- Be sure to inform patients regarding a procedure before placing a “consent for” order so the nurse is not the first one to inform them there is a procedure ordered.
- Keep in mind that patients/families who are well informed throughout their stay are generally more ready for discharge than if they are not.