How Discharge Planners and Home Health Nurses View Their Patients

Drew, Leslie A.; Biordi, Diane; Gillies, Dee Ann

doi:10.1097/00006247-198804000-00019

Cited by 4 publications

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“…This may simply reflect the defined parameters of this category of information or the low priority assigned to it by the discharge plan-ners. Additionally, previously described differences in professional preparation and roles also may be barriers to communication (Drew et al, 1988). Particularly troubling was the finding that data concerning patient teaching done during the hospital stay as well as further teaching needed by newly referred clients or their family generally were not transferred to home care providers.…”

Section: Discussionmentioning

confidence: 97%

“…Discharge planners, usually social workers by training, are reported to perceive themselves as clear and high quality communicators who view referred patients in specific, discrete terms. Home care nurses have a holistic perspective, thus predisposing the two groups to communication problems (Drew, Biordi, & Gillies, 1988). The liaison nurse model of discharge planning, in which a community-based nurse serves as a link between the agency and the hospital, produced the greatest amount of information transfer between hospitals and home health agencies (Anderson & Helms, 1993).…”

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confidence: 99%

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Communication between continuing care organizations

Anderson

Helms

1995

Research in Nursing & Health

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Communication between health care providing organizations is fundamental to discharge planning and continuity of care, but has been reported to be inadequate. Using a classic communication model, the content of communication between hospitals and home health agencies was examined in 300 closed home care records and compared to referral content desired by practitioners. Discharge planners sent about half of the referral information recommended by the literature. Referrals consisted primarily of background data, some medical data, even less nursing care data, and almost no psychosocial data. No referral form was used by the hospital in over one third of the cases. Discrepancies existed between what client care data practitioners identified as important or desirable and the data they actually received. As responsibility for providing health care is decentralized and shared by multiple organizations, communication between providers will play a greater role in ensuring continuity of care. The findings suggest that adoption of standardized, written referral forms might facilitate clear and complete communication.

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Section: Discussionmentioning

confidence: 97%

mentioning

confidence: 99%

Communication between continuing care organizations

Anderson

Helms

1995

Research in Nursing & Health

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“…Hospital involvement in discharge planning and preparation for home care influences the effectiveness of home health service delivery, and the role of hospital staff in determining what patients are referred for home care should be considered as a component of home care effectiveness studies. Most of the research on discharge planning for home care focuses on the development or implementation of the planning process itself in terms of staff or patient/family roles, timing and content of the plan, and so forth (Coulton, Dunkle, Chow, Haug & Vielhaber, 1988;Drew, Biordi, & Gillies, 1988;Dubler, 1988;Farren, 1991;Naylor, 1990;Packard-Helie & Lancaster, 1989). The findings of the research to date may improve the hospital discharge plan and the planning process, but they do not shed light on the degree to which hospital discharge planning efforts currently are effective in identifying and referring for home care those patients at highest risk for readmission or institutional placement and therefore, those most likely to benefit from home health care.…”

Section: and Marcella Griggsmentioning

confidence: 99%

Identification and referral of hospitalized patients in need of home care

Prescott

Soeken

Griggs

1995

Research in Nursing & Health

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Given current concerns about the cost-effectiveness of home health care, better targeting of home health services for high risk groups is viewed as one way to provide controls on both service delivery and costs. The purpose of this exploratory study was to determine the degree to which patients with identifiable levels of need for services were referred for home health care and if selected clinical and functional status measures are useful in distinguishing need for service. Using a convenience sample of 145 patients ready for hospital discharge, data were collected on physical function, dependency at discharge, perceived helpfulness of others, social support, readiness for self-care, and planned adherence to treatment as well as demographic and medical variables. Using a combination of study variables, 93% of patients not in need of services could be correctly classified. In addition, patients in need of service but not referred by their physicians were found to differ significantly from patients not in need of care on all dimensions. Suggestions are offered for further research to determine if and what systematic factors influence referral decisions for home health care and which specific patient characteristics are associated with the most cost-effective long-term outcomes.

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“…Some teams include community nurses and families, the rationale being that such arrangements bring a more holistic family-based approach to the assessmentplanning process (Drew et al 1988). Neary argues that such teams improve within-hospital and hospitalcommunity communication (Neary & Kitchen 1990).…”

Section: Planningmentioning

confidence: 99%

Discharge planning: issues and challenges for gerontological nursing. A critique of the literature

Jackson

1994

Journal of Advanced Nursing

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Families are rapidly becoming unpaid givers of complex care. Using McKeehan & Coulton's systems model, this critique reviews the evolution of the structure and processes of discharge planning programmes. It explores three common assumptions: discharge planning programmes are cost-effective, allow for enhancement of patients' and families' quality of life, and ensure continuity of care between hospital and community. Funds are saved due to decreased lengths of initial hospital admissions and readmission rates. However, the cost of additional hospital and community resources is rarely considered. Little evidence supports the concept that discharge planning directly affects a patient's health status. Patients and families often do not perceive the same level of benefit from discharge planning as do health professionals. Several issues surrounding research methodologies used in the reviewed studies are identified. Of particular concern is the lack of qualitative research into patients' and families' experiences. The critique concludes with an exploration of ethical issues and challenges arising from increased emphasis on cost-effective discharge planning. These include patients' rights, provision of sufficient human, social and financial resources, improved hospital-community communications, and control over hospital-developed but community-implemented programmes.

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How Discharge Planners and Home Health Nurses View Their Patients

Cited by 4 publications

References 0 publications

Communication between continuing care organizations

Communication between continuing care organizations

Identification and referral of hospitalized patients in need of home care

Discharge planning: issues and challenges for gerontological nursing. A critique of the literature

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