Designing a Discharge Planner Role at AUBMC

Abstract

Discharge planning, is an accreditation required process, developed to improve the quality of care and solve the post discharge health problems that may arise due to poor self-care management.

Between 2015 and 2021, patients reported gaps in the discharge process at AUBMC to Registered Nurses in the ambulatory specialty clinics. In order to understand the reasons behind these gaps, observation of the actual discharge process was done on a medical surgical unit at AUBMC for 6 weeks during as a residency. Results of the process mapping showed delays in the discharge process and gaps in patients’ discharge instructions related to lack of communication and coordination among healthcare providers on one hand, and patients and their family or caregivers on the other hand. Reasons for the discharge process gaps relate to overworked healthcare teams and shortage in nursing staff. The aim of this project, is to design a Discharge Planner role at AUBMC to address the gaps in the patient discharge process. A framework is created for the design of the discharge planner job. This framework is based on the scientific management theory and two models, the job characteristics model and the patient-centered model. The proposed job description includes competencies, scope of responsibilities and functions of the discharge planner. An implementation plan of the role is described including financial feasibility, force-field analysis for the acceptance of this new role, and evaluation of the impact of the discharge planner role.