New form gets more information more quickly

Check boxes speed process

A new discharge planning form developed by a total quality management team at Noble Hospital in Westfield, MA, has drawn praise from the physicians and nurses who use it, pleas from nursing home administrators to buy it, and requests from a national organization for sample copies.

"When we decided to form a TQM [total quality management] team, we just wanted to make the discharge process more efficient," says JoAnn Hunt-Millard, MSW, LCSW, CCM, director of social services and team co-leader. "Never in our wildest dreams did we expect to get the recognition we’ve had for this form."

The discharge form that had been used at Noble for several years was complicated and lengthy, says Hunt-Millard. Physicians were overwhelmed by paperwork and often didn’t include enough information on the form.

The new form, while asking for more information, makes the task easier by asking the physician or nurse to check off the orders requested.

"There are prompts telling [the practitioner] what to put in each section," notes Ann Reichert, clinical instructor in the department of education. "Before, it was a blank form and you had to remember all of the services you needed to order for the patient."

"The new form is more efficient, asks for more information, and takes less time to fill out," says Hunt-Millard. There is one page for physicians, one for nurses, and one for other disciplines. Each page has four parts so a completed form can be given to the receiving facility, put in the patient’s charts at the hospital and physician’s office, and filed in the hospital’s social services department.

In addition, the new form contains informa-tion — such as do-not-resuscitate orders and information on whether the patient has a health care proxy — that was unheard of when the previous form was developed. In developing the form, the hospital team asked for input from everyone who uses it, both inside and outside the hospital. This included nurses, physicians, staff at home health care agencies, and nursing homes, Hunt-Millard says. "This was definitely an interdisciplinary process."

A surveyor from the Joint Commission on Accreditation of Health Care Organizations who visited the hospital was particularly impressed with the form’s second page, which is multidisciplinary, adds Reichert. "It’s a most concise collection of patient information. In the past [the various departments] wrote paragraphs on the discharge. With the check boxes, it’s easier to read and quicker to get information for whoever is receiving the patient."