Helen was being discharged from the hospital on a Saturday. To make sure everything went smoothly, I took steps you can also take in a similar situation:
- Ask the “discharge planner” (who may be a social worker, nurse, or other specialist) how all the patient’s medical records will be transferred to the skilled nursing facility, so that they have the complete information they need to care properly for the patient when the patient arrives.
I was told that all the information would be sent electronically, up to date through Friday afternoon. I confirmed with the skilled nursing facility that they routinely get such information from this hospital. They explained how it would get from their Records department Friday afternoon to the nursing station before Helen arrived.
- Ask the patient’s nurse to give you a copy of the discharge instructions. If the patient is discharged in the evening or on a weekend, these would not be in the materials sent electronically earlier during normal business hours.
The nurse reviewed with me three pages, which clearly listed the drugs prescribed, drugs Helen was taking before coming to the hospital that she should not take any longer, and so forth.
- Find out if the ambulance driver will bring other paperwork, and watch to make sure that it goes with the gurney (stretcher) when the patient does.
- Talk with the skilled nursing facility to answer any questions and address any issues that concern you.
In Helen’s case, I asked them to make sure the toilet seat in her room was high enough for someone who’d just had hip surgery. I asked them to get any doctor’s orders needed to continue nutritional supplements (high-calorie shakes and ice cream packed with extra protein and nutrients). I explained why the surgeon was limiting her pain medicine to Tylenol.
I told them about the temporary brace on her leg, and what the surgeon had said about care for the surgical incision.
They asked me if she’d had general anesthesia and what drugs were used. I answered these questions. They asked exactly what parts had been replaced, and I emailed them an x-ray I had gotten by taking a photo of it on my smartphone when the nurse showed it to me on the computer.
- Verify that the nurse calls the skilled nursing facility to provide last-minute updates about the patient’s condition that wouldn’t have been in the paperwork previously sent electronically.
- Call the skilled nursing facility as the ambulance is leaving, giving them an estimated time of arrival.
Having taken these useful and appropriate steps, I thought that I had covered all the bases. I was sadly mistaken. Next week’s column will explain what went wrong.
