Specialty Solutions Spotlight: Effective Hospital Discharge Planning Starts Earlier Than You Think

What should I do to prepare for a hospital discharge? 

When an injured employee is medically ready to leave the hospital, it doesn’t mean everything they need will be waiting when they return home or transfer to a facility. For an adjuster, the key to successful discharge planning is recognizing when coordination will be complex and choosing the right resources early.

Hospital discharge referrals are often requested for the same or next day and can be difficult to manage when patients live in rural locations, provider availability is limited, or requests are made on a weekend or evening. Most requests require a variety of services involving multiple providers, authorizations, appointments and equipment delivery with very little notice. Injured employees may also need assistance with facility care coordination between a hospital stay and returning home.   

What’s at Risk Without Proactive Discharge Planning

When discharge services aren’t in place managing daily care becomes difficult. Here are just a few reasons advance planning is important.

• Injured employees without family support may not be able to care for themselves alone at home
• Safety could be compromised, resulting in readmissions or delayed improvement
•  Injured employees may not have the equipment needed to perform daily activities
• Personal hygiene, proper nutrition, and medication adherence can be at risk
• Lack of transportation can interfere with rehabilitation, getting to appointments and the ability to leave home 
• Delays in arranging nursing, medical supplies or other services can disrupt recovery. 

There’s an administrative burden for adjusters as well. Coordinating a discharge means working with the hospital, case manager, multiple vendors, the injured employee and their family while also arranging equipment, transportation, home health and other services. On a complex claim, those moving pieces can add significant work at a time when decisions need to happen quickly.

Without careful planning, injured employees can become frustrated with their situation and could turn to litigation for resolution. Adjusters coordinating their discharge alone can feel overloaded with scattered details, time delays and additional expenses that don’t serve the injured employee or the employer. 

Proactive Planning for Hospital Discharge 

The best time to plan a hospital discharge is as soon as you know the injured employee will be admitted to the hospital, such as when surgery is first scheduled, and engage a discharge planning resource as early as possible.

Pay particular attention when the discharge involves several specialty services or is a complex injury. An average hospital discharge involves seven items or services, while catastrophic cases typically involve 10 or more. Here are some common discharge referral requests.

• Durable medical equipment (DME) and medical supplies, such as wheelchairs, walkers, hospital beds or wound care equipment
• Home health services, including skilled nursing or in-home therapy
• Transportation to the home, another facility or medical appointments
• Physical and occupational therapy
• Home modifications or other specialty services

Missing information can slow coordination, particularly when a request arrives shortly before discharge. An order for a walker may not answer questions about the type, size or features needed. Transportation could require wheelchair or stretcher service. Whether the patient requires a skilled nursing facility or inpatient rehabilitation facility. When adjusters partner with a knowledgeable specialty coordinator, they will ensure upfront questions are addressed before orders are placed or services are scheduled.

What to Look for in a Discharge Coordination Program

Effective discharge planning programs should include several features: 

• Proactive coordination of products and services before discharge
• Year-round availability, 24 hours a day, seven days a week
• National provider coverage for all types of services
• Collaboration with hospitals, providers, case managers and adjusters
• Ability to secure services promptly
• Skilled professionals who understand the complexities of workers’ compensation cases, work-related injuries and return-to-work objectives
• Coordination of complex or catastrophic cases with multiple parties

Hospital discharge can move quickly. Planning ahead makes sure the services ordered for the next stage of care are ready when they’re needed. When a discharge involves multiple specialty services or a tight timeline, an early referral to a specialty coordinator like Apricus can provide a single resource to manage multiple details for adjusters so they can focus on the claim. Case managers continue to guide care plans overall, while a specialty coordinator handles the logistics needed for them, and the injured employee and their family benefit from having one central contact for all the products and services they need to recover.

To make a referral for specialty products and services, call 877.203.9899 or email apricus.referrals@enlyte.com.

To read more Specialty Solutions Spotlight articles, visit enlyte.com/specialty-solutions-spotlight.

This information is meant to serve as a general overview, and any specific questions should be fully reviewed with a health care professional or specialty service provider.