Recovery-Focused Practices and Discharge Planning - Background, Rationale, and Suggested Implementation Strategies

Background, Rationale, and Suggested Implementation Strategies

HMS Bundle Measures on Data Reports - Recovery Practices
  • Baseline functional status was assessed(≥4 I/ADLs documented)
  • PT/OT consultation
  • Assessment and documentation of goals of care
HMS Bundle Measures on Data Reports - Discharge Planning
  • Post-discharge phone call made to patient within 3 calendar days
  • Anticipatory guidance for symptom monitoring
  • Hospital contact provided for issues post discharge
  • Scheduled for PCP follow-up within 2 weeks
  • Appropriate continuation of medications for chronic disease management on discharge
  • Appropriate discontinuation/non-use of controlled substances on discharge
Strategies to Achieve Measures
  • Implement practices to reduce post sepsis and post ICU syndrome
  • Sepsis team evaluates current state of discharge process and recovery focused practices
  • Consider implementing Project RED discharge process

 

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