How does working with consumers influence discharge planning?

You increase patient understanding.

 
Typically, hospital discharge processes are not created with a patient's perspective in mind. By incorporating feedback and working with patients before and after discharge, the discharge process can be vastly improved, particularly in reducing the number of avoidable hospital readmissions.
 
4.4 million hospital readmissions cost the nation $30 billion each year, and reducing readmissions is a top priority. Patients who are well educated on how to take care of themselves after discharge are less like to be readmitted.
 
Multidisciplinary discharge planning at the bedside takes place at St. Mary’s Medical Center in Maine. The care team includes nurses, a physician, a case manager, a social worker, a physical or occupational therapist, and a pastoral care team representative. A nurse gives a brief presentation to each patient with input from the care team, including the patient. This approach is a shift from traditional discharge planning, which occurs behind closed doors without patient input. Tammy Joly, RN, BSN, says, “It gives (patients an) additional opportunity to understand the diagnosis they are dealing with.” Survey results show that most patients feel that in addition to having an opportunity to participate, they also were given an active role in their plan of care. 
 
The Cleveland Alliance used a collaborative approach to reducing readmissions that knits together hospitals as well as individual patients. Caseworkers’ roles are re-conceptualized as “transitional coaches” responsible for establishing relationships with patients while they are in the hospital and scheduling follow-up appointments before discharge. The pilot was successful, with only one readmission within 30 days. Since then, the program has expanded. 
 
An Oregon Alliance initiative aims to reduce avoidable readmissions by using coaches who encourage patients to take an active role in managing their own care. Coaches make home visits and follow-up phone calls to address medication reconciliation, signs and symptoms for patients to monitor, follow-up appointments with primary care providers or specialists, and personal health records.