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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.
Know where you will go after you are discharged. You may go home or to a nursing facility.
If you go home, you may need visits from a home health care nurse. It may be advisable for a friend or family member to stay with you after you are home. If possible, make these arrangements before you are admitted to the hospital.
You may need special care such as a special diet, shots, or bandage changes. Sometimes nurses come to your home for this, but family or friends may also help with these if possible.
Some new medications may have been started in the hospital. Know their doses, side effects, and the reason you are receiving them. You may need a prescription and to know which pharmacy to go to. You may continue some of your old medications, but the doses may change. Some of your regular medications may not have been given in the hospital and you may need to start taking them again. Your new medications may need insurance preapproval.
You may need durable medical equipment (DME) at home. This includes walkers or supplemental oxygen. Make sure you know how to get DME after you leave the hospital and how insurance pays for it.
Know what activities you can do. Will you be able to bathe or use the stairs? If you cannot drive, plan how you will get to doctors' appointments, pick up your prescriptions, and handle other chores like grocery shopping.
Know which health care professionals you will see after you are discharged. They should receive a full report of your hospital stay. You may need treatments such as physical therapy. Make sure these appointments are made for you, and ensure that the providers of these services get a report summarizing your hospital stay.
Most hospitals have discharge planners on staff. These professionals are often nurses or social workers who are well informed about community resources to put your plan in place. They can also direct you to the appropriate people to help ensure that your insurance pays for the care you are covered for and let you know what you have to pay for.
You should receive a written summary of your health status. It should tell you what was done in the hospital and provide specific instructions regarding your need for medications, treatments, and follow-up. Bring this with you to your doctors' appointments or any time you seek medical care. Know who to call if questions come up after you are discharged.
Medicare discharge planning checklist http://www.medicare.gov/pubs/pdf/11376.pdf
Florida Department of Health http://www.doh.state.fl.us/phnursing/dischargeplanning.html
New York State Department of Health http://www.health.ny.gov /professionals/patients /discharge_planning/
Agency for Healthcare Research and Quality http://www.innovations.ahrq.gov/content.aspx?id=1777
To find this and previous JAMA Patient Pages, go to the Patient Page index on JAMA 's website at www.jama.com. Many are available in English and Spanish.
Sources: Medicare, Florida Department of Health, New York State Department of Health, Agency for Healthcare Research and Quality
The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call 312/464-0776.
Topic: HEALTH CARE BASICS
Goodman DM, Burke AE, Livingston EH. Discharge Planning. JAMA. 2013;309(4):406. doi:10.1001/jama.2012.145192
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