Discharge planning

A programme of work focusing on the ‘Last 1000 Days’ has been established to bring together a number of programmes aligned to good discharge planning. From December 2019 projects under the workstreams of pyjama paralysis, red days, green days and criteria-led discharge will be launched. I will provide a full report on the programme to our commissioners in January.

I would like to comment on an example of how our discharge processes are changing based on learning from some recent poorly managed discharges that I expressed concern over.

A gentleman from a rural town was cleared for discharge on a Saturday morning. His wife did not drive, they could not afford to hire an ambulance and no shuttle was available. His family who lived a distance away were not able to collect him. He was safe for discharge and previously he may have been a candidate for the InterCity bus as a way of getting him home over a weekend.

Learning from previous situations further discussion and options were explored. These included transport options such as Driving Miss Daisy, fleet car (driven by staff member) using backload option of ambulances from Tokoroa (where the ambulance was delivering a patient and returning back to base empty) or taxi hire.

The patient did stay in hospital overnight in order to organise this because the ambulance backload option was available the following day.

It is good to see staff are clearly reflecting on recent issues – we need to review whether other options could have been utilised to get the gentleman home safely the day he was fit for discharge.