The Nurse’s Contribution to Discharge Planning

Wednesday, August 10th, 2011
This post was written by Cheryl Miller

Johns Hopkins’ nurses play an essential role in the discharge planning process, explains Chad Boult, MD, MPH, MBA, professor of public health, medicine & nursing and director of the Lipitz Center for Integrated Health Care, Johns Hopkins Bloomberg School of Public Health.

Question: What’s the role of the nurse in discharge planning for the comorbid population?

Response: In our model, the nurse doesn’t do the discharge planning. There are some transitional care models where the nurse does do it and every hospital has to have a discharge planner, but we rely on the discharge planner to make the plan. Our nurse interacts with the discharge planner to make sure that they know everything they need to know about the patient for whom they’re making the plan. Most discharge planners have no idea of the patient’s home circumstances. However, our nurse has been to the home and makes sure the planners know the capabilities at home and tries to ensure that a good plan is made. Importantly, our nurses visit the home the day of or day after discharge. That’s when the opportunity is greatest to resolve the confusion that’s almost always going on in patients who have complicated problems, have had their medications adjusted and then are sent home.

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