Can you start discharge planning even before admission?


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The Beryl Institute just released some findings from their upcoming “The State of Patient Experience 2013” report. Highlights include:

  • Not as many people are positive on their progress to improve the patient experience.
  • HCAHPS scores and leadership’s desires are the motivators to improve.
  • 81% of hospitals have a formal structure for addressing patient experience.

Top priorities for improvement include reducing noise, pain management, discharge processes, and hourly rounding.

In regards to discharge planning, Parkview Health found success with readmissions prevention by starting the process at admission. In an article and live webcast with HealthLeaders magazine they describe their reasoning:

“Typically in the last two hours of the admission the nurse is trying to get everything done and the patient’s thinking about getting home, and it’s not an ideal state for learning, retention, and understanding… So one of the things we’re doing is we’ve moved our discharge education to begin at the day of admission.”

The health system found that early, consistent contact helps build a relationship with the patient, and that is what makes all the difference.

I say that for scheduled surgeries, discharge planning can start even earlier than admission. Using an online patient guidance system, hospitals have started educating and setting expectations for the patient before they even step through the hospital doors. Web forms collect important discharge planning information and deliver it to care coordinators who can create a plan and address potential issues in advance of the surgery day. Imagine how much more patients can be engaged in their discharge decisions when they are not groggy from pain meds and the impact of surgery.

Whenever you bring up technology to address patient experience concerns, some ask, “Are we using HIT to outsource patient engagement?” Robert Green argues in his blog, HIT is not meant to replace personal interactions, but enhance them. These online communications can extend the relationship beyond the hospital walls and keep it going over time. Also, automation can speed up some ineffecient manual systems that steal time from patient interactions.

While patient satisfaction/experience was noted as the #1 priority for hospitals again this year in more than one survey, there is a distinct gap about how their patients see and interact with them from afar. How do your fast growing numbers of “e-patients”, armed with their always-connected devices interact with you from home, and are you creating patient partnerships that go beyond your walls? Take our Free ePatient Experience Assessment to see your current state of readiness to engage with e-patients.


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