Dhruv Khullar

New research now suggests multiple strategies to improve the patient  discharge process at hospitals,  such as treating it more like the admissions process and dispensing medications at that point.

Dhruv Khullar, M.D.,  a resident physician at Massachusetts General Hospital and Harvard Medical School, noted in a New York Times blog entry that at teaching hospitals in particular, junior residents usually thoroughly interview patients, often sharing any information gleaned with senior residents and the physician in charge to develop a plan of care.

Dr. Khullar recommends incorporating the attention to detail in the admissions process into the discharge process. For example, follow-up phone calls helped William S. Middleton Memorial Veterans Hospital, in Madison, Wis., cut admissions 11 percent.

Another good move is dispensing medications to patients ahead of discharge, says a study  in Pediatrics, reports FierceHealthcare. “Discharging patients with medications in hand significantly lowered the odds of readmission, leading Boston University Medical Center to add medication dispensation to its discharge protocols,  says Pharmacy Times.”

Fierce  also cites  a program to  patients manage the discharge process at home.  As part of the program, providers identify high-risk patients and implement discharge plans over a 30-day period after a “warm handoff,” according to Healio. Providers implementing the program report readmission rates of 17 percent.

Fierce adds: “Hospital design may hold potential keys to improving discharge as well; since introducing a transitional care center on the first floor of its trauma tower, San Antonio’s University Health System has reduced patients’ time spent in bed after discharge, Healthcare Design reports, with a goal of sending 30 percent of discharge patients through the unit over the course of the year.”