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CMW Tip of the Week: Screen patients to establish potential discharge planning hold-ups

Case Management Weekly, August 20, 2008

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This week’s tip comes from Jackie Birmingham, RN, BSN, MS, CMAC.

Although all patients need discharge planning, not all patients have discharge planning problems. Screening should be done for all patients to determine whether they fit into established screening criteria or have “out of the ordinary” circumstances of admission. Any patient admitted may have discharge planning problems, regardless of a seemingly risk-free situation.

To screen patients, establish criteria that indicate high-risk and develop a method of identifying a patient who meets them. Each medical service, such as orthopedics, cardiology, or pediatrics, should identify criteria that constitute high risk for discharge planning needs.

Examples of risk factors include the following:

• High risk diagnosis (e.g., cancer, trauma)
• New onset functional deficit affecting self-care (e.g., stroke)
• Chronic disease with an acute exacerbation or a new diagnosis (e.g., Chronic Obstructive Pulmonary Disease, stroke)
• Potentially problematic social history (e.g., lives alone or with an impaired caregiver)
• Suspicion of abuse, neglect, abandonment, or exploitation
• Mental status changes (e.g., dementia)

Have a tip you’d like to share? Or maybe a question for our experts? Email it to editor jmcginley@hcpro.com.Your thoughts could be featured in the next issue of Case Management Weekly!

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