PHILADELPHIA — Hospitals should consider establishing discharge centers staffed by multi-disciplinary teams to work with families and patients in reducing readmissions, according to an accompanying editorial published online now in JAMA Internal Medicine authored by a Perelman School of Medicine University of Pennsylvania researcher.
A discharge center aimed first at older patients and then possibly expanded to include all patients could decrease fragmentation of care often found in hospitals today and thus improve patient outcomes and reduce readmissions, says the editorial by Karin V. Rhodes, MD, MS, assistant professor and director of Health Care Policy Research in the Department of Emergency Medicine at Penn. Consequences of this fragmentation include patients not knowing the complete reasons they were admitted to the hospital, inadequate advance notice about their discharge, and the absence of a full discharge plan understood by patients and their families.
The discharge center would be staffed by geriatric specialists, advanced practice nurses, and pharmacists, with access to health educators, therapists, nutritionists, and social workers. The team would be responsible for coordinating the transfer of patients from inpatient to outpatient care. It would conduct holistic patient assessments, including comprehensive reviews of physical and mental health, medication, risk-assessments, home and family conditions, and related matters. It would also provide information to patients and their families (or caregivers in nursing and assisted-living facilities) to help patients remain healthy. The team would be available around-the-clock to respond to questions and problems after discharge.
“Having a team and center dedicated to the discharge process has the potential to improve overall hospital quality and efficiency,” said Rhodes. “It might even reduce admissions in the first place or reduce the length of stay by providing admitting physicians with confidence that patients will get needed medication, education, and follow-up care in a comprehensive, coordinated fashion.”
The Penn-authored JAMA editorial is in reference to "Quality of discharge practices and patient understanding at an academic medical center" by Horwitz et al, also published online now.
Penn Medicine is one of the world's leading academic medical centers, dedicated to the related missions of medical education, biomedical research, and excellence in patient care. Penn Medicine consists of the Raymond and Ruth Perelman School of Medicine at the University of Pennsylvania (founded in 1765 as the nation's first medical school) and the University of Pennsylvania Health System, which together form a $4.3 billion enterprise.
The Perelman School of Medicine has been ranked among the top five medical schools in the United States for the past 17 years, according to U.S. News & World Report's survey of research-oriented medical schools. The School is consistently among the nation's top recipients of funding from the National Institutes of Health, with $392 million awarded in the 2013 fiscal year.
The University of Pennsylvania Health System's patient care facilities include: The Hospital of the University of Pennsylvania -- recognized as one of the nation's top "Honor Roll" hospitals by U.S. News & World Report; Penn Presbyterian Medical Center; Chester County Hospital; Penn Wissahickon Hospice; and Pennsylvania Hospital -- the nation's first hospital, founded in 1751. Additional affiliated inpatient care facilities and services throughout the Philadelphia region include Chestnut Hill Hospital and Good Shepherd Penn Partners, a partnership between Good Shepherd Rehabilitation Network and Penn Medicine.
Penn Medicine is committed to improving lives and health through a variety of community-based programs and activities. In fiscal year 2013, Penn Medicine provided $814 million to benefit our community.
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