Sue Dill Calloway, RN, MSN, JD, CPHRM, CCM, CCP, president of Patient Safety Education and Consulting in Dublin, OH, relates two stories from real life to illustrate how discharge planning is closely aligned with patient safety.
Several years ago, Dill Calloway’s mother, who was 85 at the time, was admitted to the hospital after she went to the emergency department complaining of chest pain. She received a CT scan, was placed on a cardiac monitor, and admitted. After several days, the admitting physician concluded that she was having chest wall pain.
“Her family physician had discontinued her non-steroidal anti-inflammatory medication which was causing the chest wall pain,” Dill Calloway says. Dill Calloway was out of town and asked her sister, who was at the hospital, to make sure she was discharged with a prescription for an anti-inflammatory medication.
The attending physician instructed the family to call the primary care physician for an appointment and to get the prescription then. The case manager did not intervene. Her primary care appointment was scheduled for two days after discharge but in a day-and-a-half, she was back in the hospital with a blood clot.
“Without the anti-inflammatory medication, my mother was in too much pain to move. She stayed in bed with the heating pad and developed the pulmonary embolism. This became a patient safety issue caused by poor discharge planning,” she says.
In contrast, a few months ago, Dill Calloway’s mother was hospitalized after a serious automobile accident. When she no longer met inpatient criteria, she still could barely walk. The discharge planner arranged for a stay in a rehabilitation facility.
“The discharge planner made sure they were meeting her needs after discharge. She could barely walk with a walker when she went to rehab. If they had just sent her home, even with home health visits, she could have fallen and been readmitted or even died. This is an example of how good discharge planning promotes patient safety,” Dill Calloway says.