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October 2014

Planning for Effective Hospital Discharge

Author Affiliations
  • 1The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
JAMA Pediatr. 2014;168(10):890-891. doi:10.1001/jamapediatrics.2014.1028

Hospital discharges occur more than 35 million times per year in the United States and the process of discharging the patient is one of very few processes common to all hospitalizations where the patients survive. Patients’ safety is at risk when discharge plans do not ensure that the patients, their families, and their caregivers have the knowledge and support they need to thrive beyond the hospital’s walls. Hospital costs increase and access to beds for new patients diminish when discharges are delayed. Despite the importance, frequency, and universality of hospital discharges, the process is one characterized by substantial variability within and between hospitals and a lack of generally accepted goals. Unfortunately, the process of discharging a patient rarely follows a clear plan and is, too often, an ad hoc assembly of actions identified on an as-needed basis. We might consider that, to paraphrase Antoine de Saint-Exupéry, a goal of a safe and timely discharge without a plan is but a wish.

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