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Walk the Even Hospital Database by book and chapter — the raw source passages that ground Ask, DDx, and the rest.
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Effective collaboration is the key to successful discharge planning. The discharge planning process involves an interprofessional team approach. Physicians are responsible for deciding the patient is safe for discharge, creating the discharge plan in conjunction with the rest of the team, and communicating instructions to the discharge nurse or designated discharge personnel.[13] While having a well-thought-out discharge plan is important, it is just as critical to communicate this plan to the necessary providers and the patient. By communicating the discharge plan effectively to the patient, the provider can impact the quality of care the patient receives.[10] This is particularly important for elderly patients, who likely have a more complex discharge plan and require more assistance in executing its necessary elements. Discharge planning may include nurses, therapists, social workers, patients, family members, physicians, occupational and physical therapists, case managers, caregivers, and, at times, insurance companies.[7] Each patient's discharge plan is customized to their situation and may not involve all of these specialists. The effectiveness of discharge planning is difficult to evaluate due to the complexity of the intervention and the numerous variables involved.[14] The quality of discharge planning correlates with a lowered readmission rate within 30 days, which directly affects reimbursement from Medicare and Medicaid.[15] In the United States, efforts by the Department of Defense to implement TRICARE allows patients to consolidate their personal healthcare information to create their own healthcare homepage.[10] This can help patients and future caregivers understand the patient's follow-up plan. Furthermore, the information provided to the patient at the time of discharge fosters better communication among the physicians, the patient, and the patient's family.[16] Patient loyalty to return to the same hospital for readmission is associated with the quality of discharge planning.[15]