Telephone interpretation services can also be used if a person is unavailable to provide in-person information . Wheeled computer interpreting systems are available and can be pushed into the room as needed . With advancements in technology , even cell phone applications can provide accurate interpretation . However , these types of apps and devices should be approved by the facility .
Telephone and Electronic Follow-Up
Data compiled by the Veterans Administration showed that a phone follow-up and counseling after discharge eased the transition and lowered rates of repeated hospitalizations ( Singh Joy , 2013 ). In more than 40 % of calls , patients had a follow-up question for the RN or provider ( Agency for Healthcare Research and Quality , 2014 ). With the advent of electronic medical records , patients are able to review their care , including labs results and active prescriptions . These systems make it easier to communicate with providers via secure confidential messaging systems from a patient portal ( Shenson , Cronin , Davis , Chen , & Jackson , 2015 ).
ED-Made Appointments
One reason for ED discharge failure is the lack of follow-up with primary care doctors or specialty clinics ( Agency for Healthcare Research and Quality , 2014 ). Using care coordination with patients to make these appointments and list them on the written discharge papers , there is a better chance that the patient will actually attend a follow-up visit .
Fall 2016 Pennsylvania Nurse 8
Barriers to Change
In order to solve problems , be innovative , and empower staff and patients , organizations must be open to change , new attitudes , and original ideas .
Stagnant Attitudes
Healthcare workers receive limited training in the communication and creation of discharge instructions ( Hill , 2014 ). Allocated resources should ensure a smoother process . Administrators should understand the importance of the last moments of the visit and invest in educating staff .
Vision
Organizations must find new ways of doing old things . Forwardthinking leaders should embrace the concepts of quality management , excellent customer service , and use of new technologies . The organizational vision must constantly progress . Sitting still in this competitive business is falling behind . There will be expectations of quality and safety improvement . Administrators and nursing leaders must be on the forefront of change with demands to improve patient safety through staff education , equipment upgrades , and immersion in the latest technologies .
Conclusion
Patient safety is jeopardized when ED staff do not take proper care in providing complete discharge teaching and written instructions . Patients receiving an outpatient discharge from the ED should receive a legible copy of complete , evidence-based , reliable , and updated discharge instructions . These should clearly explain the discharge diagnosis , follow-up instructions , how to take prescribed medications , and what to do if their condition gets worse . The instructions should be written in a patient ’ s native language and contain both graphics and text . A provider or RN should review the instructions with the patient at discharge to verify that they are correct and that the patient understands them . Patient teaching should be provided and documented in the patient ’ s chart along with discharge vital signs , pain scores , and fall assessment scores . An evaluation should be made and documented as to how the patient plans on safely getting home . If a patient decides to leave AMA , every attempt should be made to provide instructions and ethically discharge them . Lastly , the patient should sign a copy of the discharge instructions for patient records .
A hospital should always try to make a good first impression . However , the last impression matters too .
References
Agency for Healthcare Research and Quality . ( 2014 , October ). Improving the emergency department discharge process : Environmental scan report . Retrieved August 26 , 2016 from http :// www . ahrq . gov / sites / default / files / wysiwyg / professionals / systems / hospital / edenvironmentalscan / edenvironmentalscan . pdf
Albrecht , J . S ., Gruber-baldini , A ., Hirshon , J . M ., Brown , C . H ., Goldberg , R ., Rosenberg , J . H ., . . . Furuno , J . P . ( 2014 ). Hospital discharge instructions : Comprehension and compliance among older adults . Journal of General Internal Medicine , 29 ( 11 ), 1491-8 . doi : http :// dx . doi . org . library . capella . edu / 10.1007 / s11606- 014-2956-0
Arora , S ., Goldberg , A . D ., & Menchine , M . ( 2014 ). Patient impression and satisfaction of