Authors (including presenting author) :
Yu LK(1)
Affiliation :
(1)Orthopaedics and Traumatology Department, Princess Margaret Hospital
Introduction :
Patients undergoing orthopaedic procedures will experience major changes in function and daily routine after returned to home or community. It is difficult for patients or their relatives to provide suitable care after discharge, especially for patients 50 years old or above. The existing ward practice of performing pre-discharge planning is not comprehensive enough to identify patient’s potential discharge problems. It causes unnecessarily prolonged hospitalization and a less orderly process of planning. Prolonged hospitalization due to delayed discharge not only increase cost, it also increases the risk of medical complications. Before carrying out the program, in-patient average length of stay (ALOS) was 6.58 days in the pilot ward from October 2019 to September 2020. Pre-staff satisfaction survey indicated that 90% of nurses support the implementation of the program. For the above reasons, Early Discharge Planning Program is worth implementing.
Objectives :
1. Activate early discharge planning by performing nursing assessment and interventions on hospital admission. 2. Trigger an early referral of allied health professionals after nursing assessment for early arrangement to avoid delay in discharge. 3. Facilitate a safe, appropriate and suitable discharge plan.
Methodology :
Early Discharge Planning is piloted in one female orthopaedic ward from October 2020 to March 2021. Target group is all patients who are 50 years old or above. Patient’s potential discharge problems can be identified on admission by using early discharge planning checklist. Nurses could trigger early referral of allied health professionals to facilitate a suitable discharge plan. All qualified nurses applied the checklist to facilitate the pathway of early discharge planning immediately on admission. Team leader and team members coach the staff on the care plan and monitor the process of program. Staff review the assessment and interventions weekly and upon discharge. Allied health professionals are invited to join and provide the related information to facilitate the program. Old Aged Home information will be kept in ward, staff could provide it for patients and relatives as soon as possible. It can avoid unnecessarily prolonged hospitalization due to placement arrangement.
Result & Outcome :
1. To reduce the length of hospital stay and hospital readmission. 2. To shorten the screening time for referral of allied health care professionals. 3. To increase patient’s satisfaction and improve the quality of life of patients. 4. To facilitate the program confidently and consistently. 5. In-patient ALOS had dropped from 7.78days to 4.53days from September to October 2020. It had decreased dramatically by 42%. 6. Comparing the period from October to December 2019 and from October to December 2020, in-patient ALOS had decreased from 6.42days to 5.53days. There was a 14% reduction in ALOS.
