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Tweet Smears Hospital's Discharge Incentive Campaign

Cheryl Clark, for HealthLeaders Media, August 29, 2013

A tweet decrying a Baltimore hospital's effort to speed patient discharges implied that patient safety was being put at risk. How much damage was done to the hospital's reputation remains to be seen.


@Nurse_Rachel_


Tweet from @Nurse_Rachel_

The way the tweet from @Nurse_Rachel_ made it sound, a campaign by 472-bed Sinai Hospital in Baltimore rewards nurses with $10 gift cards for kicking patients out of the hospital before they're ready for discharge.

"I'm sorry very sick patient not ready to go home, but I want to win a $10 gift card!" read one inflammatory tweet from the account of Rachel Amanda, RN, whose profile boasts, "Here to care for you. Baltimore." Another of her tweets  about the incentive program that began Monday is pictured at right.

What she tweeted was hardly the true story, which I'll explain in a moment. But the damage was already done; the tweet was rapidly retweeted. (And has since been taken down.)

@Nurse_Rachel_'s followers, including journalists and healthcare providers, piled on, appending their retweets with expletive-laced comments. "What?! That's crazy," "Grossly misguided" and "nice to see patient safety comes first," they wrote.

Naturally I was intrigued. In my decades of healthcare reporting, I've seen campaigns with original good intentions painfully backfire, with opposite consequences smearing a hospital's reputation.

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6 comments on "Tweet Smears Hospital's Discharge Incentive Campaign"


LL (8/30/2013 at 12:38 AM)
I think the real issue is the fact that the nurse tweeted about it. Nothing wrong with the program and I'm sure there was no ill-will. But, from a PR perspective, sending the tweet was a fail. You never want to put your employer in a reactionary & defensive position. Especially when the intent was meant to improve, not harm. I'm not sure I understand why some people continue to tweet exactly what they are thinking. And you definitely don't want to do that when it relates to your job.

Christine Pittman (8/29/2013 at 7:26 PM)
I don't agree with an employee of any institution voicing a concern over Twitter, especially in a manner that leaves out the facts. Having said that, we should consider the crucial information that is exchanged during the discharge process. The nurse, pharmacy and case management staff must interpret and respond to the provider's discharge orders. Those roles are responsible for giving the patient and family their best opportunity to succeed in the post hospitalization period. Just as the spokesperson said, Nursing staff has a lot to do to finalize paperwork, communicate discharge instructions to the patients and family, arrange for transportation, find the patients' belongings, and continue to care for other patients." In addition, there may be prescritions that just showed up to be filled, follow up appointments to be made, discrepancies to be resolved, etc. This is not McDonalds. We have to do the right thing and make certain the patient is set up for positive outcomes.

Nursenat67 (8/29/2013 at 3:07 PM)
Sadly, there are some nurses who "lolly gag" because they don't want to get the time consuming admission. All discharges must have a Physician's order and that is up to his or her medical judgement.