Background
Effective discharge planning and well-coordinated case management related to nursing
home (NH) placement are key services in acute-care hospitals.
Objectives
(1) identify the individuals and important factors involved in the discharge planning
process; (2) describe the types/sources of information used by discharge planners
to recommend specific nursing homes for patients and families; and (3) determine which
methods are used to evaluate the quality of US nursing homes (NHs).
Methods
Descriptive study, with a convenience sample of 41 discharge planners and case managers
from California acute-care hospitals.
Results
This study found that patients, families, friends, and physicians are all involved
in the discharge planning process along with discharge planners and/or case managers.
Discharge planners/case managers were generally concerned about NH bed availability,
geographic location, and financial considerations. Although the discharge planners
and case managers were able to articulate important indicators of quality in NHs,
such information was not routinely considered during discharge planning activities.
Conclusions
Discharge planners and case managers need to play a more central role in the decision-making
process related to the selection of a NH, especially because decisions are time-limited
and can benefit from a well-planned discharge planning program that uses a variety
of data on quality and costs. The widespread use of Internet-based information sources
can be expanded to aid this process.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Nursing OutlookAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Searching for and selecting a nursing facility.Med Care Research Review. 2003; 60: 223-247
- Discharge planning and social work practice.Social Work Hlth Care. 2000; 32: 1-19
- Health spending rebound continues in 2002.Hlth Affairs. 2004; 23: 147-159
- Descriptive study of models of discharge planning and case management in California. University of California, San Francisco1992 (PhD Dissertation)
- Models of nursing care delivery and case management.Nurs Eon. 1993; 11: 163-178
Joint Commission on Accreditation of Healthcare Organizations [JCAHO]. (2004). 2004 Hospital Accreditation Standards.
- Patient centered long-term care.Hlth Care Financing Review. 1997; 19: 1-10
- Improving hospital discharge planning for elderly patients.Hlth Care Financing Review. 1997; 19: 47-72
- Wunderlich G.S. Kohler P. Improving the quality of long-term care. National Academy of Sciences, Washington, DC2001
- Nursing homes: additional steps needed to strengthen enforcement of Federal Quality Standards. Report to the Special Committee on Aging, US Senate. GAO/HEHS-99-46. US General Accounting Office, Washington, DC1999
- Designing a report card for nursing homes.Gerontologist. 2003; 43 (Special Issue II): 47-57
- Searches for a nursing home.J Applied Gerontol. 1998; 17: 352-371
- America’s online pursuits. 2003 (Available at: http://www.pewInternet.org/reports/toc.asp?Report=106 Accessed December 29)
- Federal and state nursing facility websites.Am J Med Quality. 2003; 18: 21-37
- Wunderlich G.S. Sloan F.A. Davis C.K. Committee on the Adequacy of Nurse Staffing in Hospitals and Nursing Homes. Nursing staff in hospitals and nursing homes: is it adequate? National Academy Press, Washington, DC1996
- Nursing home survey and certification: deficiency trends. OEI-02-98-00331. Inspector General, Washington, DC1999
US Centers for Medicare and Medicaid Services (CMS), Prepared by Abt Associates Inc. Appropriateness of Minimum Nurse Staffing Ratios in Nursing Homes. Report to Congress: Phase II Final. Volumes I-III. Baltimore, MD: CMS, 2001.
- The National Nursing Home Survey.Vital Hlth Statistics. 2002; 13: 1-117
- The changing profile of nursing home residents: 1985–1997. National Center for Health Statistics, aging trends No. 4. 2001 (Available at: http://www.cdc.gov/nchs/data/Agingtrends)
- Quality report cards and nursing home quality.Gerontologist. 2003; 43 (Special Issue II): 58-66
- HHS fact sheet. HCFA press Office, Washington, DC1998
- Validation of long-term and post-acute-care quality indicators. 2002 (CMS Contract No 500-95-0062/T.O. #4)
U.S. House of Representatives, Committee on Government Reform. HHS ‘Nursing Home Compare’ has major flaws. Report Prepared for Rep. Henry A. Waxman and Sen. Charles E. Grassley. Washington, DC: US House, 2002.
- Websites.J Gerontol Nurs. 2003; 29: 5-11
- Website Statistical Report for calnhs.org. Oakland, CA. 2003
- Components of a proper hospital discharge for elders.J Adv Nurs. 2001; 35: 571-581
- The diversity of case management models.Lippincott’s Case Management. 2002; 7: 212-220
- Discharge planning.Social Work Hlth Care. 1997; 26: 41-60
- Performance indicators for discharge planning.Australian J Adv Nurs. 1999; 16: 20-28
Parkes J, Sheppard S. Discharge planning from hospital to home (Cochrane Review). In: the Cochrane Library, Issue 2. On-Line Available at: http://212.49.218.200/?newgenMB/ASP/printDocumnet.asp Accessed July 18, 2003.
- Multiple perceptions of discharge planning in one urban hospital.Hlth Social Work. 1995; 20: 254-261
California Office of Statewide Health Planning and Development (COSHPD). Hospital Cost Report Data, 2001–2002. Sacramento, CA: OSHPD33, 2003.
- Managing the incongruities.Applied Nurs Research. 1994; 7: 125-131
- Positions of influence in the nursing home admission decision.Research Aging. 1997; 19: 26-45
- Case management information systems.Lippincott’s Case Management. 2002; 7: 255-260
- Discharge planning.J Clin Nurs. 2000; 9: 594-601
Biography
Eric Collier is a Doctoral Student at The Department of Social and Behavioral Sciences, School of Nursing, University of California, San Francisco, San Francisco, CA.
Biography
Charlene Harrington is a Professor of Nursing and Sociology at the Department of Social and Behavioral Sciences, School of Nursing, San Francisco, San Francisco, CA.
Article info
Footnotes
This article and the development of California Nursing Home Search Website, was funded by the California HealthCare Foundation. (Grant Number 03-1342)
Identification
Copyright
© 2005 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
