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Tweet Smears Hospital's Discharge Incentive Campaign

Cheryl Clark, for HealthLeaders Media, August 29, 2013

The tweet from @Nurse_Rachel_, Haley adds, "was taken completely out of context. It sounds like we're trying to get people out of the hospital before they're ready," but what was communicated to staff in management meetings "was completely different. We want to raise our (nurses') awareness of this issue to try to increase our patient satisfaction, and give them a little incentive as they go. Not a big deal."

These days, with an emphasis on healthcare system efficiency and speedy throughput, it's important for hospitals that regularly have a full census to make room for new patients. That's not wrong, nor tough to understand. It's certainly not poor quality of care if the patient is ready to go home. I messaged @Nurse_Rachel_ to contact me, to get her version of this campaign. She did not.

Haley explains that the hospital was doing the right thing, responding to negative feedback from Press Ganey surveys from patients who said that after being approved for discharge, they waited too long, between 30 minutes in the best scenario, up to "several hours."

"Due to the multiple complaints, this issue has risen to the top of our priority list, and the incentive for the nursing staff is one example of how we are working to improve the process," Haley wrote me in an e-mail.

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, she says.

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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.