Social Work Discharge Planning in Acute Care Hospitals in Israel: Clients’ Evaluation of the Discharge Planning Process and Adequacy

Abstract

Objective: To examine the associations of patients' characteristics, hospitalization factors, and the patients' or family assessment of the discharge planning process, with their evaluation of adequacy of the discharge plan. Method: A prospective study. Social workers from 11 acute care hospitals in Israel provided data on 1426 discharged patients. At 2-week postdischarge, 407 patients and 659 family members evaluated the discharge planning process (information received, involvement, influence) and adequacy. Results: More family (77%) than patients (62%) assessed the discharge planning to be adequate. Discharge process variables contributed more than patient or hospitalization characteristics to evaluation of adequacy but had a negligible mediation effect. Factors significantly associated with higher adequacy of plans were: hospital ward, receiving information, high family involvement, and discharge destination among patients; receiving of information and high patient and family involvement among family respondents. Conclusions: Social workers should actively involve patients and family in discharge planning.

Discharge from the acute hospital: trauma patients’ perceptions of care

“…Previous literature has shown that non-injury-related considerations, such as funding arrangements and compensation status, are significant factors relating to patient discharge to in-patient rehabilitation after an acute hospital stay, 4,35 but patients in this cohort seemed unaware of the significance of their funding arrangements in terms of discharge choices. This seemingly inconsistent response does not appear to relate to a specific hospital or patient type and is similar to that found in other studies, 8,9,11,12 with the sense of urgency regarding the decision making, 9 combined with the stress of an injury and acute hospital stay, perhaps leading to the feelings of lack of control over decisions. 11 The use of bedside tools to guide decision-making in orthopaedic trauma, such as the sTRaPT, 33 may assist in increasing patient involvement and understanding of the process and aims of hospital discharge.…”

“…This is similar to findings reported in other studies in both acute care and in an older cohort. 8,12 Themes not described before in the literature but present in this cohort are participants reporting variable attitudes towards their in-patient rehabilitation stay and readiness for discharge, including a desire to leave the in-patient rehabilitation facility before completion of formal discharge processes. Provision of information and organisation of follow-up care was a source of frustration for many participants, especially those discharged home from the acute hospital.…”

“…6 Patient involvement in discharge decision-making appears to be the most significant factor in determining discharge disposition in the elective orthopaedic population, 7 and patient involvement in decision-making is shown to lead to greater satisfaction following acute hospital care. 8 There are no studies on patient perspectives of discharge destination decisionmaking following orthopaedic trauma. Following acute care, patients have, in general, expressed concern with the lack of information regarding discharge 9,10 and lack of participation in the discharge process.…”

Developing Positive Attitudes Toward Interprofessional Collaboration Among Students in the Health Care Professions

“…Social workers' skills in collaborative practice are critical to effective functioning by interprofessional teams (Howe, Hyer, Mellor, Lindeman, & Luptak, 2001). For example, hospital-based geriatric social workers on interdisciplinary care teams assess high-risk patients, develop discharge plans, and coordinate postdischarge follow-up services (Soskolne, Kaplan, Ben-Shahar, Stanger, & Auslander, 2010).…”

The Clarity and Contribution of the Hospital Social Work Role: Observations on its Professional Identity

“…Yet, not all delayed discharges are attributable to social care; indeed NHS England (2016) reported that 60 per cent of delayed transfers of care were attributable to the NHS while only 21 per cent occurred because of problems in arranging suitable home support. Similar supply problems rather than lack of professional input or skill have been observed in Israel (Soskolne et al 2010), with its parallels to the UK in terms of almost universal access to healthcare but where social care services are much more restricted for those who cannot pay.…”