Discharge Plan chp 6 Flashcards
What is the primary responsibility of the acute care OT? which is also a complex process that involves OT’s clinical reasoning skills, experi- ence, appreciation for client and contextual factors, and knowledge of health care guidelines and disposition options.
Discharge Planning
The primary focus of OT in acute care
quality of life and self-identity
autonomy promotion
encouraging independence
risk avoidance
preventing adverse effects of a decision
self-determination
the right to make their own decisions
beneficence
concern for the well-being of the patient
Medicare Prospective Payment System (PPS),
In 1983, the federal government mandated the Medicare Prospective Payment System (PPS), instead of a fee-for-service–based system, to control health care spending. Hospitals’ reimbursement became a set fee per patient on the basis of the patient’s diagnosis-related group (DRG), regardless of the actual cost of services (Bushnell, 2013).
Hospital Consumer Assessment of Healthcare Providers and Systems Survey (HCAHPS)
In 2006, CMS developed the Hospital Consumer Assessment of Healthcare Providers and Systems Survey (HCAHPS) to measure patient satisfaction (CMS, n.d.). Survey data are publicly reported and available to consumers. The survey includes 10 items for capturing discharge information, responsiveness of hospital staff, and physician–nurse communication.
The Patient Protection and Affordable Care Act
The Patient Protection and Affordable Care Act (ACA P. L. 111– 148) was signed into law in 2010, in part to improve quality of care (Lamb & Metzler, 2014). Several key points are used to determine the definition of quality: cost containment, patient satisfaction, reduc- tion of readmissions within 30 days of discharge, and health manage- ment of specific populations.
The primary risk factors for patient readmission within 30 days of discharge include
Living alone, Having unmet ADL and IADL functional need, Lacking skills for carryover of medical and health care regimen recommendations, and Having limited education
Rehabilitation potential
is the capacity for recovery if the patient re- ceives rehabilitation services
To optimize discharge outcomes, the therapist–patient relationship should be
collaborative
Patients and their families prefer a guiding approach to the discharge process
which means that the therapist takes time to clearly ascertain the issues facing the patient and caregiver, anticipates challenges at the next level of care, and proactively helps resolve them with the appropriate level of instruction and follow-through.
Disposition sites are
places to which a patient might be discharged. The potential disposition sites in the full continuum of care
