Improving patient transitions from hospital to long-term care

¶ … people feel more comfortable when their loved ones are comfortable and are in environments where they feel safe and are close to the people they love. Long-term healthcare therefore provides people with this option whereby there is upholding of an individual's independence as well as their ability to continue with their normal routine as possible. Therefore the long-term healthcare aims to provide in-home care for those who crucially need it and at the same time allowing individuals to remain in the homes as long as possible, regardless of their age or disability. There have been various challenges faced by patients as they transition from the hospitals to the long-term healthcare facilities within the healthcare system that is fragmented. Within the long-term healthcare organization there are various challenges faced, one of the issues include an intake department that lacks effectiveness when it comes to organization of referrals and relating appropriate material to the visiting nurse prior to home visit. This paper will therefore look at a plan on the proposal of how the issue can be solved.

Proposed plan

The issue of transition of a patient from the hospital to the long-term-health care centre is very important. This is due to the fact that services provided in the long-term healthcare are individualized and one is able to get all the attention that they need. There should be assurance that a smooth transition takes place. The proposed plan should include the following; first there should be improvement in the logistics within the intake department to ensure that referrals are made and reach the facility in good time. This means that processing of the referrals should be done immediately and fast expedited so that there are no pending cases. This can be done with the creation of another department; a logistics department alongside the intake department, that will work together to ensure that the referrals are processed within the shortest time possible. This starts from the doctors in the nursing rehab facilities giving a patient the actual go ahead for them to be moved from the hospital to the long-term healthcare. Therefore when a doctor sees the need of a patient to go into the long-term healthcare they should give a referral immediately. The same logistics department should ensures that the equipment that is to be used in the facility gets there in time this will be done through quick processing of documents of the equipment to be used. With this department in place it means that the equipment will reach the facility in time and therefore used by the patients that are being admitted.

The plan should also include the collaboration of the organization with insurance companies that ensures that any payments that are to be made by the insurance are done and processed within the shortest time possible. Therefore this means that there are no delays with the intake department when it comes to the admissions of the patients into the centre and also reducing delays at the discharge after recommendation of transfer or referral.

Need for the changes proposed

Too much time is wasted between making of referrals, processing of the referrals and the actual admission of patients into the facility. These changes are essential for the organization as they will ensure that the least time is taken to make referrals. At the same time very little time is also taken for the processing of the referrals once recommended. The changes are important as they will ensure that patients take the least possible time to move from the hospitals to the home care facility. Therefore the changes are very important when it comes to the welfare of the patient as well as the quality services offered by the facility.

Factors influencing the proposed change

There are various factors informing the proposed changes in the transfer process. The first reason is that these changes will make work easier for employees of the concerned organization if successfully implemented. The other factor is in full interest of the comfort of the patients who need close and keen attention without a lapse in any service required. The delays after recommendation of the referrals essentially mean the patient will be missing the essential care that they should get at the home care facility.

Factors influencing organizational readiness for the proposed change

There are various factors influencing the readiness of the organization for the proposed change. These factors include the availability of resources needed to facilitate these changes. These changes can only take place if the organization has enough resources. Among these resources are finances as well as adequate personnel to ensure that the changes are implemented effectively.

Another factor that influences the readiness of the organization is effective communication. Effective communication systems within the facility is crucial. This is because effective communication ensures that there is great understanding of all the requirements needed in the changes to be made and hence with everyone understanding the requirements they will work towards that.

Theoretical model of the proposed change

Changes within an organization might be under different models that usually represent the different aspects of the organization and they vary considerably. The particular theoretical model of the proposed changes is the systems theory. This is due to the fact that the components of the organization are interconnected and they work in at equilibrium. Even small changes that are made in a particular area affect major changes in other areas. This means that the changes from the creation of the new department as well as the communication and collaboration within the departments facilitates this change and hence the systems theory (Consador, 2012). The system theory also works well in this situation since there will be need to fully embrace the electronic data storage to expedite all the processes around the client.

Internal and external resources available to support the change initiative

There are various resources that are available to ensure that the changes are supported. Among the internal resources are personnel, there should be employees who are ready and willing to work towards the proposed changes. Funds are made available by the organization to ensure that the changes are implemented without any problems. Internally, there is also the need for the administration full support to the changes that will be initiated.

Among the external resources are insurance companies who will work together with the facility when it comes to processing of the insurance payments. There are also other external organizations that can fund the facility to ensure that these changes are a success. The external factors will also involve the mutual communication between the involved bodies; the insurance, hospital and the home care facility.