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  1. Educate the patient and family in plain language about the patient’s condition, the discharge process, and next steps throughout the hospital stay. Assess how well doctors and nurses explain the diagnosis, condition, and next steps in the patient’s care to the patient and family and use teach back.

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  2. The goal of the IDEAL Discharge Planning strategy is to engage patients and family members in the transition from hospital to home, with the goal of reducing adverse events and preventable readmissions.

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  3. INSPIRED 2.0 invites and engages the client in the planning for and understanding of their disease (Patient-Focused) Care Providers: Case-Managers, Respiratory Educators and other Interdisciplinary Team members as required. Care Components match the COPD Discharge Bundle.

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    • Marianne E. Weiss
    • Ronda G. Hughes
    • Recommended Citation
    • Marianne E. Weiss
    • Kathleen L. Bobay
    • Sarah J. Bahr
    • Linda Costa
    • Ronda G. Hughes
    • Implications for Nurse Leaders
    • Conclusion

    Marquette University, marianne.weiss@marquette.edu

    Marquette University, ronda.hughes@marquette.edu See next page for additional authors Follow this and additional works at: https://epublications.marquette.edu/nursing_fac Part of the Nursing Commons

    Weiss, Marianne E.; Bobay, Kathleen; Bahr, Sarah J.; Costa, Linda L.; Hughes, Ronda G.; and Holland, Diane

    College of Nursing, Marquette University, Milwaukee, WI

    College of Nursing, Marquette University, Milwaukee, WI

    College of Nursing, Marquette University, Milwaukee, WI

    School of Nursing, University of Maryland, Baltimore Baltimore, MD

    College of Nursing, Marquette University, Milwaukee, WI

    The proposed conceptual model for hospital discharge preparation (Figure 1) can serve as a guiding structure for ensuring that the 3 major components of discharge (discharge planning, discharge coordination, and discharge teaching) are fully operationalized, with role functions and relationships clearly delineated. With many existing and emerging p...

    The conceptual model for hospital discharge preparation (Figure 1) coalesces the many existing components used in discharge and care transition processes into a comprehensive framework for hospital discharge activities. Compilation of components of transitional care models that are initiated in the hospitalization phase of care provides a menu of o...

    • Marianne E. Weiss, Kathleen L. Bobay, Sarah J. Bahr, Linda Costa, Ronda G. Hughes, Diane E. Holland
    • 2015
  4. DISCHARGE PLANNING TOOLKIT INTRODUCTION. Discharge planning involves a coordinated effort between the patient/resident, caregiving professionals, family members, and community supports. It is intended to smooth the transition from facility care to a home setting, or alternate facility.

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  5. Apr 3, 2023 · Discharge planning may include nurses, therapists, social workers, patients, family members, physicians, occupational and physical therapists, case managers, caregivers, and at times, insurance companies. Each patient's discharge plan is customized to their own particular situation and may not necessarily involve all of these specialists.

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  7. Discharge planning is the process by which the hospital team considers what support might be required by the patient in the community, refers the patient to these services, and then liaises with these services to manage the patient’s discharge.

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