Discharge to Home from Hospital (Care Package)

© Copyright 2019 Grief Probate Journey Blog *PLEASE NOTE THIS INFORMATION IS SOURCED FROM UK and AMERICAN WEBSITES* It is also based on our own experience. *We are not experts in this field, we are speaking purely on our own experience with information sought from the internet to give further examples.*

Please see Discharge to Home from Hospital (Care Package) which includes:

  1. Introduction/Our Story
  2. Hospital Discharge
  3. Hospital Discharge Process
  4. Illustrative Example: Questions Caregivers should ask
  5. Failed/Delayed Discharge
  6. Patients Rights
  7. Hospital at Home (Including YouTube video)
  8. Palliative Care
  9. Useful Links
  10. Our Final Thoughts

1. Introduction/Our Story

This wasn’t a planned topic. Randomly whilst watching an ambulance documentary, mental health services were involved when visiting someone that had called the ambulance. This person was a frequent ambulance caller daily. This person was disabled and called daily stating he had suffered a seizure. The mental health team concluded this person was not suffering from mental health issues, it was a social services issue. This was down to the fact their care package wasn’t sufficient due to their disability which had left them socially isolated. Because of this, the mental health team advised social services need to be contacted.

When the mental health person was talking not to begin with, but once I realised what he was saying the feeling I got inside was indescribable. It started making me feel all sorts of ways. Which then made me feel this needs to be a topic.

Our Dad was discharged to home and the care package was not sufficient at all. We battled with the hospital to try and get this amended as it was more than clear the package they put together was in no way sufficient for our Dad or his condition since being an inpatient at the hospital.

It’s so strange how things can just transport you back to these sorts of memories when you least expect it.

In honesty though, the experience of our Dad being in the hospital and his unfortunate passing away made me unable to watch 24 hours in a&e. This was because I couldn’t bear to see the inside of a hospital, Ill patients, patient’s passing away. What made it even worse is this would sometimes be filmed at the hospital our Dad was an inpatient. The point I am making here is that because this was not such a programme, I wasn’t prepared for how it made me feel. However, it is not a bad thing, as we feel this is a good topic to cover. Please see Discharge to Home from Hospital (Care Package):

^Top

2. Hospital Discharge

2.1 What is a hospital discharge plan?

“Hospital discharge planning is a process that determines the kind of care you need after you leave the hospital. Your discharge plan should include information about where you will be discharged to, the types of care you need, and who will provide that care”.

2.2 What is discharge process?

“To improve patient discharge, the current process of discharging patients from hospital (the discharge process) needs evaluating to determine where and why medication issues occur. One significant finding was a lack of patient involvement in the discharge process”.

2.3 How many steps discharge planning?

“10 steps”

“The 10 steps of discharge planning

For simple discharges carried out at ward level, the process should be standardised throughout an entire hospital”. (17 Jan 2013)

2.4 Being discharged from hospital – NHS

“Collect your hospital discharge letter for your GP or arrange to have it sent directly to them. ensure you have the medication you need. get a copy of your care plan (if applicable) – if you’re being discharged to a care home, the home should be told the date and time of your discharge, and have a copy of the care plan”.

2.5 What is the hospital discharge process?

“When you leave a hospital after treatment, you go through a process called hospital discharge. A hospital will discharge you when you no longer need to receive inpatient care and can go home. This person helps coordinate the information and care you’ll need after you leave”.

2.6 How do you get discharge from hospital?

When you leave a hospital after treatment, you go through a process called hospital discharge. A hospital will discharge you when you no longer need to receive inpatient care and can go home. Or, a hospital will discharge you to send you to another type of facility.

2.7 What is medically fit for discharge?

“Medically Fit For Discharge. A significant number of hospital beds are occupied by patients who. are deemed “Medically Fit For Discharge“, sometimes for long periods of. time. These patients are generally elderly and awaiting social services/” (15 Nov 2007)

^Top

3. Hospital Discharge Process

3.1 What is the hospital discharge process?

“When you leave a hospital after treatment, you go through a process called hospital discharge. A hospital will discharge you when you no longer need to receive inpatient care and can go home. This person helps coordinate the information and care you’ll need after you leave”.

3.2 What does discharge planning involve?

“Discharge planning is an interdisciplinary approach to continuity of care and a process that includes identification, assessment, goal setting, planning, implementation, coordination, and evaluation”.

3.3 How do you plan a discharge?

“The key principles of effective discharge planning”

  1. “The 10 steps of discharge planning”.
  2. “Start planning before or on admission”.
  3. “Identify whether the patient has simple or complex needs”.
  4. “Develop a clinical management plan within 24 hours of admission”.
  5. “Coordinate the discharge or transfer process”.
  6. “Set an expected date of discharge within 48 hours of admission”.

More items… (17 Jan 2013)

3.4 When should a patient discharge planning begin?

“Discharge Planning. The process of discharge planning prepares you to leave the hospital. It should begin soon after you are admitted to the hospital and at least several days before your planned discharge. The January 23/30, 2013, issue of JAMA has several articles on readmissions after discharge from the hospital”.

3.5 What is included in a hospital discharge summary?

“What to include. The Joint Commission mandates that discharge summaries contain certain components: reason for hospitalization, significant findings, procedures and treatment provided, patient’s discharge condition, patient and family instructions, and attending physician’s signature”.

3.6 What is a Section 2 in hospital discharge?

“A Section 2 requires an NHS body to notify social services of a patient’s likely need for community care services after discharge. The Act sets out the requirement for social services care management to assess within 3 days. A Section 5 notifies social services of the proposed date of the patient’s discharge”.

3.7 What does a hospital discharge social worker do?

“In helping the patient get access to resources the social worker does an assessment of financial, social, and psychological resources available to the patient and family; coordination with other medical staff to facilitate the discharge plan; documentation to produce a written record of what has been and needs to be”.

3.8 What does a discharge nurse do?

“Provide a more effective discharge process for patients and a supportive work environment for nurses. Innovation: Staff created a special staff position—the unit-based discharge nurse—who is responsible for providing support to clinical nurses, patients and other team members to expedite patient discharge”. (4 Jun 2008).

3.9 Why are discharge instructions important?

“The importance of providing adequate discharge instructions to communicate with both patients and primary care physicians cannot be overstated. Discharge instructions serve a number of important purposes. They inform the patient of the known, suspected, or preliminary diagnosis and the name of their treating physician”.

3.10 What is medically fit for discharge?

“Medically Fit For Discharge. A significant number of hospital beds are occupied by patients who. are deemed “Medically Fit For Discharge“, sometimes for long periods of. time. These patients are generally elderly and awaiting social services” (/15 Nov 2007).

^Top

4. Illustrative Example: Questions Caregivers should ask

^Top

5. Failed/Delayed Discharge

5.1 What is a delayed discharge from hospital?

“A delayed discharge occurs when a patient, clinically ready for discharge, cannot leave hospital because the other necessary care, support or accommodation for them is not readily accessible and/or funding is not available, for example to purchase a care home place”.

5.2 What is a failed discharge from hospital?

“Within the definition of a ‘failed discharge‘. The definition the Trust is using for a failed discharge is “Failed. discharges are when a patient has been re-admitted within 48 hours of. being discharged from the hospital because sufficient measures were not. put in place”. (23 Nov 2015)

5.3 Can you sue a hospital for early discharge?

“In most early discharge cases, patients are readmitted to a hospital under emergency conditions. The patient may be able to sue for any preventable harm, i.e. damages that would not have occurred if the patient had not been discharged from the hospital in the first place”.

5.4 What is a safe discharge from hospital?

Safe discharge” laws preclude hospitals from discharging patients who don’t have a safe plan for continued care after they leave a hospital. … Hospitals are required by the Emergency Medical Treatment and Labor Act (EMTALA) to accept all “emergency” patients, but nursing home facilities are not. (1 May 2016)

^Top

6. Patients rights

6.1 NHS Patients’ Right – Citizens Advice

“Information on the rights of clients within the national health service including some of your rights as an NHS patient are set out in the NHS constitution. The Care Quality Commission checks all hospitals and providers of primary health. A GP will only visit you at home if they think that your medical condition requires it”.

6.2 What are rights of a patient?

“Patient rights are those basic rule of conduct between patients and medical caregivers as well as the institutions and people that support them. A patient is anyone who has requested to be evaluated by or who is being evaluated by any healthcare professional”.

6.3 Can a patient request to be transferred to another hospital?

“A patient cannot be transferred to another hospital for any non-medical reasons, such as inability to pay, unless all of the following conditions are met: … The patient’s medical records (including a “transfer summary” signed by the transferring physician) are transferred with the patient”. (11 Apr 2016).

In our case, with our Dad, when he had been diagnosed with his condition(s), in a meeting with the lead consultant at that time on the ward he was on said as he is on a new ward this is his second opinion. But what my Dad meant by this is he wanted a second opinion from another hospital. Our Dad was a very intelligent man, and he must have felt and known something wasn’t right. We wish we had pushed further for this second external opinion to take place.

6.4 Can a hospital discharge a patient who has nowhere to go?

“What do hospitals do when a patient has nowhere to go after being discharged? Many patients will return to their home or nursing facility/assisted living or previous level of care. Some will go to a nursing facility temporarily for rehab until they can safely return home”. (29 Apr 2018).

6.5 Can I refuse discharge from hospital?

“Refusing a Proposed Discharge”

“If a hospital proposes an inappropriate discharge, you may refuse to go. Although you cannot stay in a hospital indefinitely, the hospital cannot discharge someone needing long term care until it arranges safe and adequate follow–up care”. (11 Sep 2018).

6.6 Can a hospital make you got to a nursing home?

“Can a hospital force a patient to go to a long term nursing facility or short term skilled nursing facility (SNF)? The answer is no. No doctor, no nurse, no physical, occupational or speech therapist anywhere in America can force you or your loved one to go anywhere you or they don’t want to go”.

6.7 What are the rights of a patient?

“For example, a legal definition is as follows; patient rights is general statement adopted by most healthcare professionals, covering such matters as access to care, patient dignity, confidentiality, and consent to treatment”.

6.8 Do you get 6 week’s free care?

“Most people receive this type of care for around 1 or 2 weeks, although it can be free for a maximum of 6 weeks. It will depend on how soon you are able to cope at home. If you need care for longer than 6 weeksyou‘ll have to pay for it”.

^Top

7. Hospital at Home (Including YouTube Video)

7.1 What is hospital at home UK?

“Hospital at Home. Hospital at Home provides acute healthcare to patients in the comfort of their own home. The service is delivered by our team of specially trained nurses who visit each patient in their home to deliver the care they need”.

Had we known about this option at the time our Dad was an inpatient in the hospital, we definitely would have requested this. Without a doubt, we strongly believe had this been an option for our Dad at the time the outcome would have been completely different unfortunately we will never be able to know as its too late now. Our Dad was an independent man. His time in the hospital was the longest time he’d ever spent not in his home, on a daily basis he wanted to know when he was going home. He missed his home his missed his independence.

7.2 Hosptial At Home: University College London Hopsitals NHS Foundation Trust

7.3 Video Hospital at Home – North Bristol NHS Trust

7.4 What is hospital at home care?

“BACKGROUND: Hospital-at-home is defined as a service that provides active treatment by health care professionals, in the patient’s home, of a condition that otherwise would require acute hospital in-patient care, always for a limited period”.

7.5 Hospital at home

“Hospital in the Home (HITH) provides admitted care in the comfort of the patient’s home or other suitable location. Research findings demonstrate that patients have improved outcomes and recovery at home with fewer complications such as infection, delirium and confusion. HITH is an alternative to an inpatient stay”.

7.6 Hospital at Home USA

“Hospital at Home® provides safe, high-quality, hospital-level care to older adults in the comfort of their own homes. … If your hospital wants to implement Hospital at Home in a safe and effective manner, contact us to learn more”.

7.7 What is hospital at home care?

“BACKGROUND: Hospital-at-home is defined as a service that provides active treatment by health care professionals, in the patient’s home, of a condition that otherwise would require acute hospital in-patient care, always for a limited period.”

7.8 What is hospital in the home?

“Hospital in the Home (HITH) provides admitted care in the comfort of the patient’s home or other suitable location. … Patients are still regarded as hospital inpatients, and remain under the care of their hospital doctor”. (5 Oct 2015)

7.9 Who qualifies for home care services?

“You need, and a doctor certifies that you need, one or more of these”:

  • “Intermittent skilled nursing care (other than drawing blood)”
  • “Physical therapy”.
  • “Speech-language pathology services”.
  • “Continued occupational therapy” (23 Apr 2018)

^Top

8. Palliative Care

8.1 When should someone be offered palliative care?

“You may start palliative care at any stage of your illness, even as soon as you receive a diagnosis and begin treatment. You don’t have to wait until your disease has reached an advanced stage or when you’re in the final months of life. In fact, the earlier you start palliative care, the better”. (16 Aug 2019)

8.2 What is the difference between palliative care and end of life care?

“The goal is to improve your quality of life and that of your family, friends and carers. End of life and palliative care is based on what your needs are, not your diagnosis. If you have an illness that cannot be cured and will lead to the end of your life, end of life and palliative care will be suggested”. (17 Sep 2015)

8.3 Does the NHS pay for end of life care?

“Paying for your care”

“NHS continuing healthcare means a package of care that is arranged and funded by the NHS, and is free of charge to the person receiving the care. … Read more about what you can expect from end of life care”.

^Top

9. Useful Links

^Top

10. Our Final Thoughts

Once it was decided this was to be a topic, we did not know what we might find out. We didn’t necessarily think we could/would find out something that we wish we had known when our Dad was an inpatient in the hospital. It is very upsetting for us as we can never know now what difference the hospital at home could have made for our Dad. There is nothing now that can change the unfortunate outcome.  What we do hope is this topic could possibly be of use to someone whose relative or loved one might currently be an inpatient in a hospital. In these sorts of situations, knowledge really is key.

^Top

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

This site uses Akismet to reduce spam. Learn how your comment data is processed.