One of the PATH ALONG models dynamic components involves a completed nursing summary. The Joint Commisssion's hospital certification process includes a nursing summary requirement. The UW Wisconsin School of Medicine and Public Health in December 2011 published study results in the Journal Of Internal Medicine "Discharge Summaries Play A Key Role In Keeping Nursing Home Patients Safe". The study supports the importance of having a completed nursing summary in the patients hands upon discharge.
The nursing summary will communicate details on the patients hospital stay and identify future care needs. The above study listed the critical importance of receiving the information delivered in this document within an immediate time frame. The more time that lapses between discharge and the delivery of the information in the nursing summary the less value the document has for patient recovery.
The nursing summary lists ongoing patient needs as the person transitions from the hospital setting. Have the medications changed, and new treatments been ordered. How does meal prep relate to the physical changes of the diagnosis for hospitalization. Activity specifics related to physical therapy. Follow up appointments that have been scheduled and those that still need to be made. Ongoing lab monitoring. Special individualized concerns hospital staff noted with the patient stay.
PATH ALONG staff expect the patient to receive a hard copy of the nursing summary and an electronic record to be retained in the hospital data storage. The information communicated should include patient status at admission and discharge, resolved and unresolved problems, and referrals that have been made.
PATH ALONG is an original Wisconsin model that connects inpatient providers to community staff who support the patient during health system transitions. The goal is to reduce the hospital readmission rate. PATH ALONG is an evidence based model with 3 defined services to help the hospitalist fulfill their continuity of care role. The focus is on care filled transitions.
Check out the progress on the PATH ALONG app http://appsmakerstore.com/appim/j6kcdet8xvwk4s
Call 608-432-4286 or email lkutzke@homecarepath.onmicrosoft.com to discuss scheduling service. 2013 rates are 20.00 per hour. Check out the site below with free access for more information
http://www.homecarepath.com/Pages/PRESSRELEASEOriginalWisconsinModelToReduceHospitalReadmissionRates.aspx
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