Discharge planning is a crucial aspect of patient care because it ensures that the same quality and frequency of medical care is provided in order to prevent re-hospitalization. Discharge planners coordinate a plan of care that enables the patient to obtain optimum health after leaving the hospital. So what exactly do the discharge planners do?

• Initiate discharge planning procedures. They work with the physician and the patient’s nurse to be certain that all plans are in order for the time of discharge. They verify that the patient and the family have an understanding of these.
• Initiate specific care plans with the patient’s family.
• Establish patient referrals with other health services such as physical therapy or primary care providers. They verify that the patient has out-patient appointments in place.
• Assist with other aspects of care. The discharge planner verifies that the patient has the devices needed for nursing and home care such as walkers, commodes, etc. She will also set up home care services if needed and advise of appropriate support organizations in the community.
• Teach the patient and the family. This might mean providing educational material about your diagnosis, or it might mean teaching an adult to take and record their own blood pressure, or teaching about the importance of following through on the discharge set up and plans.
• Work with team members. The discharge planner is the link between the care you receive in the hospital and when you leave the hospital.
  Advocate for the patient and the family to be sure your concerns and questions are addressed. To help you have a voice and a choice in your care.

Discharge Planning can dramatically improve the outcome for patients as they move to their next level of care.

SMC Discharge Planning

208-784-7017, ext. 339