Discharge Planning

Question 1

what is discharge planning in a medical or hospital setting

Answer 1

Planning for a client’s transition out of care to ensure a safe and smooth transfer to home or another facility

Question 2

why should discharge planning start early

Answer 2

because they can happen unexpectedly due to client choice or insurance limits

Question 3

what is the social worker’s role in discharge planning?

Answer 3

to create individualized plans, coordinate resources, ensures safety, and support smooth transition

Question 4

who is typically involved in the multidisciplinary team for discharge planning

Answer 4

nurses, doctors, PTs, OTs, nurse assistants, social worker

Question 5

what would a discharge plan include

Answer 5

Reason for discharge
Treatment goals/progress
Present functioning (bio-psycho-social)
Follow-up care
Community resources and referrals
Appointments and supports

Question 6

What are some possible discharge destinations?

Answer 6

home, relative’s home, rehab, nursing facility, hospice, another hospital, or specialty treatment center

Question 7

how should discharge instructions be delivered to clients or caregivers

Answer 7

verbally reviewed and clearly explained, not just handed over as paperwork

Question 8

why is follow-up care important in discharge planning

Answer 8

to ensure continuity of treatment, safety, and prevent rehospitalization

Question 9

what types of support might be included in a discharge plan

Answer 9

home health aides, medical equipment, counseling, transportation, housing, food assistance

Question 10

how is the discharge plan individualized

Answer 10

based on client needs, level of functioning, available supports, and discharge destination