Elderly Patients And Family Members Satisfaction With Discharge Planning

Facilitating the transition of elderly patients from the hospital setting to their pre-hospital environment is a major challenge for health care providers. Adequate discharge planning has been mandated by the Joint Commission on Accreditation of Health Care Organization (JCAHO) and the American Hospital Association (AHA). However, reports from the literature indicate that some elderly patients on Medicare may be discharged "quicker and sicker" than in the past and that care-giving family members are often not included in the discharge planning process.The problem is that elderly patients may be discharged from the hospital before appropriate discharge planning is complete. The purpose of this pilot study was to determine elderly patients' and their family members' level of satisfaction and perceptions with the overall quality of hospital discharge planning. The study addressed the following questions:. 1. What is the level of satisfaction reported by the elderly patient and the family member regarding discharge planning? 2. What are the perceptions of the elderly patient and family member with the overall quality of discharge planning? A descriptive, telephone survey design was used to determine elderly patients' and family members' satisfaction with hospital discharge planning. A telephone questionnaire was administered to a convenience sample of ten patients and ten family members between five to ten days after the patient was discharged from the hospital. The questionnaire consisted of closed-ended and open-ended questions. Demographic and closed-ended questions were analyzed using descriptive statistics, while open-ended questions were group and summarized. Satisfaction ratings were measured on a ten point scale, with ten indicating the highest satisfaction.Findings of this pilot study indicated that elderly patients and their family members were satisfied with discharge planning and that nurses were often considered the most helpful in the discharge process. Average overall patient satisfaction was 9.6 and average family member satisfaction was 8.9. Areas receiving the highest satisfaction ratings included patients being involved in their discharge planning and instructions regarding medications, obtaining equipment and supplies, and wound care. Areas in need of improvement were identified as involving both patient and family member in the process, addressing activity level, inquiring about financial concerns and the possible need for additional help at home, and providing instructions about caring for the patient in the home environment.Limitations of the pilot study as well as implications for nursing practice and education are described.Recommendations for future research are discussed.

"Nurses play a vital role in improving the safety and quality of patient car -- not only in the hospital or ambulatory treatment facility, but also of community-based care and the care performed by family members. Nurses need know what proven techniques and interventions they can use to enhance patient outcomes. To address this need, the Agency for Healthcare Research and Quality (AHRQ), with additional funding from the Robert Wood Johnson Foundation, has prepared this comprehensive, 1,400-page, handbook for nurses on patient safety and quality -- Patient Safety and Quality: An Evidence-Based Handbook for Nurses. (AHRQ Publication No. 08-0043)." - online AHRQ blurb, http://www.ahrq.gov/qual/nurseshdbk/

Family caregiving affects millions of Americans every day, in all walks of life. At least 17.7 million individuals in the United States are caregivers of an older adult with a health or functional limitation. The nation's family caregivers provide the lion's share of long-term care for our older adult population. They are also central to older adults' access to and receipt of health care and community-based social services. Yet the need to recognize and support caregivers is among the least appreciated challenges facing the aging U.S. population. Families Caring for an Aging America examines the prevalence and nature of family caregiving of older adults and the available evidence on the effectiveness of programs, supports, and other interventions designed to support family caregivers. This report also assesses and recommends policies to address the needs of family caregivers and to minimize the barriers that they encounter in trying to meet the needs of older adults.

"In the preface to this impressive and well-produced book, the editors state that their aim is not to describe a new surgical specialty, since most surgeons will soon need to be "geriatric surgeons," but to assemble a comprehensive account that will allow "all providers of healthcare to the elderly to understand the issues involved in choosing surgery as a treatment option for their patients." This is a useful book that deserves to do well. I hope that the editors and their publisher will have the stamina to make this the first of several editions, as it is clear that updated information about surgery in the elderly will be required to keep pace with this important field." NEJM Book Review

v. 1. Research findings -- v. 2. Concepts and methodology -- v. 3. Implementation issues -- v. 4. Programs, tools and products.

Discharge Planning for Home Health Care is a comprehensive, step-by-step guide to assessing the needs of patients and establishing a coordinated hospital-to-home discharge plan. The referral format and assessment tools provide the user with an organized and systematic approach for the transition of the patient through the continuum of care. This comprehensive resource is based on current reimbursement and regulatory issues and contains over 150 tools for easy application to a broad spectrum of health care settings.

The WHO Falls Prevention for Active Ageing model provides an action plan for making progress in reducing the prevalence of falls in the older adult population. By building on the three pillars of falls prevention, the model proposes specific strategies for: 1. Building awareness of the importance of falls prevention and treatment; 2. Improving the assessment of individual, environmental, and societal factors that increase the likelihood of falls; and 3. For facilitating the design and implementation of culturally appropriate, evidence-based interventions that will significantly reduce the number of falls among older persons. The model provides strategies and solutions that will require the engagement of multiple sectors of society. It is dependent on and consistent with the vision articulated in the WHO Active Ageing Policy Framework. Although not all of the awareness, assessment, and intervention strategies identified in the model apply equally well in all regions of the world, there are significant evidence-based strategies that can be effectively implemented in all regions and cultures. The degree to which progress will be made depends on to the success in integrating falls prevention strategies into the overall health and social care agendas globally. In order to do this effectively, it is necessary to identify and implement culturally appropriate, evidence-based policies and procedures. This requires multi-sectoral, collaborations, strong commitment to public and professional education, interaction based on evidence drawn from a variety of traditional, complementary, and alternative sources. Although the understanding of the evidence-base is growing, there is much that is not yet understood. Thus, there is an urgent need for continued research in all areas of falls prevention and treatment in order to better understand the scope of the problem worldwide. In particular, more evidence of the cost-effectiveness of interconnections is needed to develop strategies that are most likely to be effective in specific setting and population sub-groups.