Chapter 3: Discharge care and planning
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Overview
This chapter addresses the planning and process of discharging patients from hospital. Discharge planning is a routine feature of healthcare systems worldwide and is recognized as the foundation of patients’ successful transitions from hospital to home (Pellett [41]). The aim of this multidisciplinary process of assessing, planning and co‐ordinating patients’ care needs prior to their leaving hospital is to ensure continuity of care with a safe and timely discharge. While discharge planning is a universal priority for all acute inpatient facilities (McNeil [26]), the process and pace of discharge planning have changed beyond all recognition (Lees‐Deutsch [20]). The increasing pressure on inpatient beds has meant that despite the clear benefits of reducing the time a patient occupies a hospital bed, ‘achieving it has proven difficult’ (NHSI [35], p.3) and effective discharge planning therefore remains one of the major challenges facing the NHS today (Winfield and Burns [54]).
Both internal and external planning processes are included in this chapter. External planning processes are those associated with the interface between primary and secondary care. They include processes related to complex discharges (including for patients with additional needs), discharge to a nursing home and discharge at the end of life.