PREPARING FOR DISCHARGE
The time of discharge from hospital is typically a busy (and sometimes overwhelming) period involving visits from many members of the healthcare team. Decisions to discharge are occasionally made on very short notice however this is not typically intended. It is helpful to know what to expect during this time and to plan ahead as best as possible to ensure the best preparation for your departure.
Essential activities that are completed on the day of (or as close to) discharge include:
Final clinical assessments / treatments by medical, nursing and allied healthcare professionals
Visit by a pharmacist to discuss discharge medications and scripts
Referral paperwork completed for services that may be recommended after discharge
Hire or purchase paperwork completed for any aids or equipment to support daily tasks such as a shower stool or walking frame
It is advisable to consider in advance any issues you may wish to address before the day of discharge arrives (wherever possible). By flagging these early, you will give the healthcare team the best chance of assisting you to achieve the best possible discharge plan. Discharge planning in advance is particularly important for those who anticipate to leave hospital over a weekend as staffing levels are typically reduced and differ from weekday personnel.
There are some simple steps that you can take to prepare for discharge. For example:
- Ask a friend or carer to help transport any new equipment to your home to ensure it is set up ahead of time.
- Tell a member of the healthcare team about any challenges you may have experienced prior to hospitalisation or those that you might anticipate occurring after discharge.
- Raise any questions about your treatment (e.g. medication side effects, need for services at home) early during your admission. Some issues require team discussions and liaising with services, which can be challenging to complete within the busy day of discharge.
- Some areas of care are best managed by community-based health services. Hospital-based healthcare staff may therefore refer you on to others for ongoing management. Make sure you understand the reasons for, and details of the referral(s).
- Telephone your GP before you leave hospital to organise a follow-up appointment within 7 days of discharge.
At the time of hospital discharge, it is common that your symptoms and physical capacity have not yet recovered to the level that they were prior to the flare-up. A deliberate plan to drive ongoing recovery following hospital discharge should be made. Lung Foundation Australia have compiled a checklist for you to work through with your healthcare team prior to leaving hospital, as a guide for planning your recovery up to 4-weeks following your discharge.
Key features of a discharge plan include:
- An updated medication plan
- A plan for follow-up with a medical practitioner
- A graduated physical activity plan
- Referral to rehabilitation (typically Pulmonary Rehabilitation)
- Smoking cessation support (if relevant)
- Follow-up plan for oxygen therapy (if relevant)
Developing an active recovery plan
The reductions in physical activity levels typically seen during COPD flare-ups do not always recover on their own after the flare-up has settled. This has been noted in studies that monitored people up to 4 and even 6 weeks after discharge. Developing a plan to ensure a good recovery for you is therefore essential after COPD flare-ups. A tailored plan to suit your needs can be developed with a physiotherapist using a form such as our early (physical) recovery plan. Pulmonary rehabilitation should be a part of this plan in most instances. Find out more about pulmonary rehabilitation in our recovery section.