Home Discharges What are hospitalists doing at discharge?

What are hospitalists doing at discharge?

June 2014

Published in the June 2014 issue of Today’s Hospitalist

WHAT TECHNIQUES ARE HOSPITALISTS USING to make sure the discharge process goes smoothly? Data from the 2013 Today’s Hospitalist Compensation & Career Survey show that while most hospitalists send a discharge summary to primary care physicians, many also use a variety of other tactics. And in the near future, hospitalists are planning to implement new discharge strategies. Here’s a look at what hospitalists say they do when discharging patients.

Actions at discharge
By far, sending a discharge summary to primary care physicians is the most commonly used strategy.

More than 90% of hospitalists said they send discharge summaries to patients’ primary care physicians. But less than half (45%) get in touch with primary care doctors in cases where a patient dies or gets a significant new diagnosis like cancer. Relatively few hospitalists reported contacting primary care physicians for all patients (17%), and even fewer (10%) schedule a follow-up call with patients.

Some hospitalists call family members or caregivers after discharge, while others send a copy of the discharge summary home. Still others pointed out that case managers or social workers in their hospitals are responsible for contacting patients after discharge.

Group strategies
Just over half (56%) of hospitalist groups report using discharge planners. That strategy was much more popular among pediatric-hospitalist groups (71%) than groups with hospitalists who treat only adults (55%).

About one-third (36%) said their groups use dedicated case managers, while 31% had someone calling patients post-discharge. Just under one-quarter (24%) said an administrative person with the group helps with discharges.

The future of discharges
When we asked how the time hospitalists spend on discharges would change in the next five years, nearly two-thirds (62%) said it would increase. About one-quarter expected the time spent to remain the same, and 6% said it will decrease.

But when we asked if hospitalists expect to do more discharge care in the near future, about one-third (36%) thought more hospital staff like NPs would be assigned to help with discharges. One-quarter (25%) said they would contact more patients after discharge.

Just under one-quarter (22%) were planning to set up or staff a post-discharge clinic, and 12% said they would be treating patients in post-acute settings like a skilled nursing facility.