2001 OPEN FORUM Abstracts
RESPIRATORYDISCHARGE PLANNING-A MULTIDISCIPLINARY APPROACH
FORMOSA, ATANASIOV. BA, RRT MARKS, ALAN RRT, HEALY, MARYANN MSN, SHERMAN, MICHAEL M.D., SCHULMAN,EDWARD M.D. PATRICK, HERBERT M.D. HAHNEMANN UNIVERSITY HOSPITAL ? TENET, BROAD AND VINE STREETS PHILADELPHIA,PA 19102
We reviewed discharge planning performedby Case Management for a six month period in cases where only respiratory serviceswere required. The analysis demonstrated a mean discharge time of 12.4hrs, aminimum discharge time of 4hrs. and a maximum time of 24hrs (n=90 patients).The statistical mode (the time which occurred most frequently to discharge)was 10.0hrs. The Department of Respiratory Care, the Division of Pulmonary andCritical Care Medicine, as well as Case Management formed a multidisciplinaryteam (January 2001) in order to expedite discharge of patients requiring respiratoryhome care. All respiratory home care referrals were processed through the Departmentof Respiratory Care as initiated by contact by physicians or Case Managers.Respiratory home care is completed with patient discharge within 0.5 hrs. Ourmean was 1.98hrs, the minimum was 0.5hrs and the maximum duration for dischargefor patients requiring extraordinary Life-Care Devices necessitating familyand patient inservicing was 24.0hrs(i.e.mechanical ventilation, NIPPV). AllDurable Medical Equipment (DME) providers were JCAHO accredited. Only RespiratoryTherapists were utilized for initial and follow up site visits at the patient?sresidence. A quality Assurance questionnaire was delivered to all patients andtheir families for monitoring services provided, including home instruction,?hands-on? training, and a competency return demonstration. DME companies providedus with follow-up information, including the patient?s condition, progress,modifications of therapy, or lack of compliance.
In conclusion we have identifieda cohort multidisciplinary model that reduced patient length of stay by one-day;expediting the discharge process and improving the quality of respiratory homecare. We have also demonstrated physician/patient satisfaction, deployed a QAprocess, and joint patient family education. Cost analysis (labor expenditure,indirect costs) for an average hospital day (Discharge after 1100a.m.) translatesinto a considerable savings and bed turn around time, for our institution Furtherfollow-up will be needed to assess continued outcome measures and track statistical targets.