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Tweet Smears Hospital's Discharge Incentive Campaign

Cheryl Clark, for HealthLeaders Media, August 29, 2013

Realistically, Sinai's goal now is to get nurses to send their patient home one hour after the physician signs the discharge order. Nurses may communicate discharge instructions to the patient and/or family the day before discharge is expected, and proactively assist with coordinating and arranging for medical equipment and supplies to be in the patient's home when they'll need it. 

Games to stimulate behavior change among healthcare workers are not a new idea. For example, in Boston a few years ago, Beth Israel Deaconess Medical Center's emergency room teams launched a game of "Tag, You're It," to catch staff lapsing in their rigorous hand-washing routines. Shamed scofflaws saw their names gracing the dashboard banners of all hospital computer monitors.

So I see nothing wrong with Sinai's campaign to creatively nudge nurses to speed throughput for patients whose continued recovery depends on them sleeping in their own beds, as long as the discharge order has been signed. Keeping patients in the hospital longer than necessary can expose them to additional risk of adverse events such as infections, falls, medication errors and other mishaps.

As Dorothy said as she was transported from the land of Oz, "there's no place like home." As long as you are medically well enough to go there.


Cheryl Clark is senior quality editor and California correspondent for HealthLeaders Media. She is a member of the Association of Health Care Journalists.
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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.