Patient Centered Discharge (PaCeD)

Abstract

A comprehensive approach to discharge planning involves (a) identifying and preparing for a patient??s anticipated healthcare needs, (b) implementing an effective care plan that meets the individual needs of the patient, (c) assessing and recommending plans of care from the interdisciplinary team members, (d) providingeducation and support to patient and caregiver(s), and (e) actively engaging the patient and caregiver(s) in the process. A patient-centered approach to the discharge process begins on the day of admission and continues throughout the course of hospitalisation. The Clinical Nurse Leader (CNL) provides expertise, leadership,guidance, and support for the improvement projects at the microsystem level. This CNL project involved the implementation of a discharge process to a 14-bed medical-surgical psychiatric unit for the elderly population at a Northern California Hospital. The goal was to provide a comprehensive approach to patientcare that would improve patient outcomes and result in a favourable hospital experience for the patient and caregiver(s). This project called PaCeD (PatientcenteredDischarge) was implemented on the unit as a performance improvement project. Patient satisfaction scores were Evaluated before and after implementation of PaCeD. After implementation of PaCeD, there was significant increase in patient satisfaction scores by 14%. Patients reported increased satisfaction in theirhospital experience and verbalised feeling more prepared for discharge. There were fiscal benefits to the organisation as no patients were readmitted to the hospital after participating in this project. PaCeD was therefore accepted and implemented as a standard practice of daily patient care to this microsystem.

KEYWORDS: clinical nurse leader, discharge, PaCeD, patient