Increasing the efficency of the Hospital discharge process
Written by Amy Morin
While many people do not like the idea of going to a hospital, inevitably most will find their way there for one reason or another.
With that in mind, hospitals need to carefully balance the risks of discharging patients too soon with the financial consequences of not discharging them soon enough. It's important for hospitals to stay up-to-date on the best care practices so they can manage their budgets and keep patients healthy.
Research about Hospital Discharges
Since hospitals are only paid for a flat rate based on the diagnosis, they don't get paid extra when patients have special circumstances or need extra inpatient days. Therefore, there's financial incentive for hospitals to discharge patients and accept new admissions.
Discharging patients too early in an effort to save money can backfire. Hospitals who discharge patients too soon experience higher rates of readmission, according to a 2012 study published in the Journal of Healthcare Management Science.
Research found that patients who were discharged at the busiest times were 50 percent more likely to be readmitted within 3 days. On the busiest days, hospitals are often pressured to get patients out the door as quickly as possible so they can accept new admissions.
Hospitals may feel forced to send home patients who could use an extra day or two in the hospital. Sometimes, they discharge patients too soon after surgery while at other times; they discharge patients who haven't fully recovered from an illness.
Solutions to Overcrowding
Proper planning can help hospitals prevent overcrowding. Elective surgeries should be scheduled carefully so that there will be plenty of available space for patients.
If elective surgeries take place on days when the census is very high, it's more likely that people will be discharged early to make room for them. When the hospital census is too high, elective surgeries should be rescheduled.
Hospitals should also be flexible about placement of post-surgery patients.
Allowing patients to be moved to floors with available beds, even if it is not the appropriate unit, can help prevent premature discharges. Placing patients on other floors is a much better option compared to sending them home.
Hospitals should provide surgeons with checklists to help them ensure that a patient is truly ready for discharge.
A clear list of discharge criteria helps surgeons, nurses, and social workers work together to ensure that patients are really ready to go home.
Hospitals can also take steps to reduce re-admissions after discharge to help save costs. Discharge planners should work carefully to ensure that patients understand the type of care they will need once they are sent home.
Also, hospitals can ensure patients have a clear plan for follow-up treatment. Setting patients up with home healthcare, for example, is one way to ensure that they will receive appropriate treatment once they go home.
Also, family education is important in reducing re-admissions. When a patient's significant other, parents or children understand the patient's needs, it can be essential in preventing readmission.
When hospitals place an emphasis on preventative care, it can cost a little more initially. However, in the long-term, it can save hospitals a lot of money by reducing re-admissions.
Investing time and resources to ensuring patients have a clear discharge plan can be a good investment for hospitals.
It can help ensure that they are able to discharge patients in a timely fashion without discharging them too soon.
About the Author
Amy Morin writes about parenting, psychology, and business topics such as Amarillo real estate.
How healthcare can safeguard itself against cyberthreats
One of the most fundamental lessons from the COVID crisis is that health should always be a priority. In a similar fashion to the human body that frequently fights off viruses and foreign invaders that intend to cause it harm, the sector itself is now a prime target for another type of external threat: cyberattacks.
The figures speak for themselves: between December and January this year, hospitals in the UK were at 89% capacity, with 7,000 fewer available beds than there usually are. As the pandemic increased pressure on hospitals, clinics, and research facilities to create a treatment for patients globally, it has left the sector exposed to hackers who, like a virus, have been targeting it relentlessly and evolving their tactics.
From patient records being held ransom, to fake emails claiming to originate from the UN WHO, the NHS, or vaccine centres, through to attacks on the cold supply chain to find out the secret formula of the COVID vaccine, the healthcare industry is facing constant cyberattacks and struggling to cope. This threat is unlikely to go away anytime soon – and as such, the industry needs to take a proactive, preventative stance to stay safe in a dynamic digital world.
The responsive nature of healthcare – particularly of hospitals – means that efficiency is crucial to the industry’s standard operations. To support this, the sector has been embracing technological advancements that can improve the quality of work, enabling staff to meet pressing deadlines, and enhancing patient care. For example, the industry has been digitising records and improving its ways of working through digital means over the past few years.
This shift is critical to offer high quality patient care; yet, it also means the sector has become more dependent on IT, which can come with a risk if cybersecurity processes employed are deemed as inadequate.
Without the correct security measures in place, the desired efficiency gains realised, can be easily lost in a heartbeat. Simply put, an elementary glitch in the system can have a tremendous ripple effect on many areas, from accessing patient records and conducting scans, to maintaining physical security and protecting the intellectual property of experimental treatment development.
To prevent this, healthcare organisations need to ensure they’re considering cybersecurity as part of their overall digital transformation strategy – and setting the right foundations to create a culture where safety goes hand in hand with patient care.
Before implementing cybersecurity process, healthcare organisations need to assess the potential risks they face. Depending on how much confidential data the trust has, where it is stored, who has access to it and via which means, the cybersecurity strategy and associated solutions will change.
It’s fair to say that a medical device start-up where all employees have a corporate-sanctioned laptop and access data via a VPN will have radically different needs to a large hospital with hundreds of frontline workers connecting to the hospital’s Wi-Fi using their personal device.
These requirements will pale by comparison to a global pharmaceutical giant with offices in multiple locations, a large R&D department researching new treatments for complex diseases and a fully integrated supply chain. Considering the existing setup and what the organisations is looking to achieve with its digital transformation strategy will therefore have an immediate impact on the cybersecurity strategy.
Despite this, there are fundamentals that any organisation should implement:
Review and test your back-up policy to ensure it is thorough and sufficient – By checking that the organisation’s back-up is running smoothly, IT teams can limit any risks of disruption in the midst of an incident and of losing data permanently.
In our recent State of Email Security report, we found that six out of ten organisations have been victims of ransomware in 2020. As a result, afflicted organisations have lost an average of six days to downtime. One third of organisations even admitted that they failed to get their data back, despite paying the ransom. In the healthcare industry, this could mean losing valuable patient records or data related to new treatments – two areas the sector cannot afford to be cavalier about.
Conduct due diligence across the organisation’s supply chain – Healthcare organisations should review their ways of working with partners, providers and regulatory institutions they work with in order to prevent any weak link in their cybersecurity chain. Without this due diligence, organisations leave themselves exposed to the risks of third party-led incidents.
Roll out mandatory cybersecurity awareness training - Healthcare organisations shouldn’t neglect the training and awareness of their entire staff – including frontline workers who may not access the corporate network on a regular basis. According to our State of Email Security report, only one fifth of organisations carry out ongoing cyber awareness training.
This suggests it is not widely considered as a fundamental part of most organisations cyber-resilience strategy, despite the fact many employees rely on their organisation’s corporate network to work. By providing systematic training, healthcare organisations can help workers at all levels better understand the current cyberthreats they face, how they could impact their organisation, the role they play in defending the networks, and develop consistent, good cybersecurity hygiene habits to limit the risks of incidents.
Consider a degree of separation – Information and Operational Technology (IT and OT) networks should be separated.
Although mutually supported and reliance on each other, employees shouldn’t be accessing one via the other. This should be complemented by a considered tried and tested contingency and resiliency plan that allows crucial services to function unabated should there be a compromise. Similarly, admin terminals should not have internet access to afford a degree of hardening and protection for these critical accounts.
As the sector becomes a common target for fraudulent and malicious activity, putting cybersecurity at the core of the organisation’s operations is critical. It will help limit the risks of disruption due to cyberattacks, reduce time spent by the cybersecurity team to resolve easily avoidable errors, and ensure that institutions can deliver patient care, safe in the knowledge that their networks are safe.
Fighting future threats
With technology continuing to change the face of healthcare, the surface area and vectors available for attacks by malicious actors is constantly increasing. With the introduction of apps, networked monitoring devices, and a need for communication, the attack vector is ever expanding, a trend that needs to be monitored and secured against.
To prevent any damage to patients, staff, or the organisation they are responsible for, healthcare leaders must put security front and centre of their digital transformation strategy. Only then can the sector harness the full benefits of technology. Doing this should include implementing cybersecurity awareness training to challenge misconceptions around security, encourage conversation, and to ensure employee knowledge of the security basics and threats faced.
This ultimately allows healthcare organisations to do what they do best: provide the highest standard of patient care, safe in the knowledge that their operations, patients, and data are safe.