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Remove discharge from the list of outcomes to improve health outcomes
Last edited 4th July 2011
Think about this? There is only one speciality where the patient isn’t discharged from the doctor’s care. The answer is general practice. Yet in most clinical jobs, the all important discharge, is the most important outcome.
Once the patient has left then it’s not my problem: until the next time.
There is tentative evidence that Patient outcomes can be improved, if after discharge to home, they are visited by the doctor who treated them in hospital in the first place.
Yet, it’s slightly confusing, although communication between Primary care docs and hospital docs was found to be pretty poor at the time of discharge. There’ no surprise in that. In one study it made no difference in terms of adverse outcomes, if the communication was good or bad.
In addition to this, many patients leave hospital with test results pending and doctors are often unaware of important actions once the patient has gone home.
Even simple things can make a difference: The risk of being admitted to hospital decreases when patients are seen after discharge by a clinician who has actually received the discharge summary. Common sense at its best.
A lot of people want to know how to save healthcare costs and reform the health service. Then the answer has to be: ask simple questions and think simple answers. If everyone in healthcare stopped seeing discharge as the outcome we’d be a lot better off.
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Health cost is also one of
Health cost is also one of the most trending issues that are being debated at present. Politicians have always batted around how Medicare payments are determined. There are presently 441 geographic payment areas for hospitals that pay on the basis of average costs in the area. In 2013, the program will give increased payments to hospitals rated as higher quality institutions. Hospitals might need short-term loans if they don’t have good enough quality. An addition to that, hospitals that are not top- performing may have their Medicare funding cut. I can see that this will be another burden to patients especially those who can't afford services from the said hospitals.
Discharge
It's interesting to read your blog and note that we experience the same challenges the world over. Continuity of care, communication, and one size fits all metrics such as length of stay.