eSigning Hospital Discharge Made Easy

Esigning hospital discharge

in early 2011 the Christiana Care 5c medical floor started an opportunity for improvement while reviewing data for 2010 we noticed a 17.6 readmission rate for congestive heart failure and COPD patients who are transferred to extended care facilities our goal was to significantly reduce our readmission rate we started by studying the problem of transition of care by looking within the hospital and then also outside with our extended care partners we learned a lot realizing that many things need to go right to effectively transition our patients oftentimes our community partners receive stacks of charting that contain non-essential information and didn't always outline the patient's course and plan of care communication between providers was seen as an area for improvement for example nurse to nurse communication was inconsistent and physician to physician communication was a rarity we felt there was room for improvement through a streamlined process that used improved communication data summary and standards of practice we felt we can make transitions safer we implemented a protocol for communication where nurse to nurse reporting and/or physician to physician communication happens with all cases before the patient leaves Christiana Care we developed an optimized transition package that features a summary of patient's stay at the unit 5c and included a customized plan of care for the patient a new role the patient care facilitator was vital in this new process patient care facilitators were added to the unit as part of a previous initiative to transform patient safety improve satisfaction and promote patient and family-centered care the patient care facilitators are nurses that act as a care facilitator patient advocate nurse leader and nurse staff mentor all in one role patient care facilitators help improve transitions and reduce readmissions through a optimized transition packet that standardizes care post hospitalization the results have been outstanding streamlining communication preparing our transitions package and standardizing care has proven to show immediate that's significant five see reduced readmissions for congestive heart failure and COPD from 17.6% in fiscal year 2010 to five point six percent in 2011 readmissions for all diagnoses declined from ten point four percent in 2010 to seven point four percent in 2011 in 2012 we saw all the diagnoses readmissions dropped to six point one percent and the rate for congestive heart failure and COPD was seven point two percent not only have our readmission rates declined but the process has placed the patient at the center of improved transitions learning from the revised processes attained on the system-wide level and the patient care facilitator role has also expanded to another unit we are proud to brought this innovative streamlined discharge process at Christiana Care it is the foundation for team-based collaborative care here in the hospital and also in our extended care community