Early Discharges from hospitals can be very detrimental to  recovery, speed of recovery and even long term health of a patient. In extreme circumstances it may even be fatal. A study showed that 20% of patients experienced adverse effects within the first 3 weeks of being discharged, of which almost 3 quarters of these cases could have been prevented or avoided (Psnet.ahrq.gov, 2019). Furthermore it was found that nearly 40% of patients that had been discharged earlier then normal had been discharged with test results still pending (Psnet.ahrq.gov, 2019).

This could be the result of hospitals rushing patients to be discharged when they were not ready to be sent home. In clinical practice I have experienced doctors pushing for discharges time and time again, when patients are not ready to be sent home. Often Doctors will contact physiotherapy departments to ask if certain patients can go home when the patient can hardly get out of bed yet alone mobilise. This could actually cause more damage to the patients psychology and even lead to further, or permanent damage both physically (if the patient hasn’t been taught how to get out of bed properly following a laparotomy, the wound can be negatively affected), and physiologically (if the patient has not been mobilised, they may feel as if they cannot walk even though they have the ability to walk).

Hesselink et al. (2012) found that many healthcare providers do not prioritise discharge consultations with patients or patients family members to find out about a possible discharge plan and whether the family is ready to accommodate the patient back into home life. It was also found that this may be due to a lack of time, or competing obligations that healthcare providers need to complete. However is a lack of time an excuse to not give each patient and their family a proper discussion as to the timing of the discharge? It was also found that there is pressure on doctors to clear hospital beds in order to cope with the ever growing demand of patients (Hesselink et al., 2012), but this factor should not limit or effect the appropriateness of a discharge. If a patient is not coping with the demands of the healthcare team then a few extra days should be given in order to treat that patient with as much respect and care as possible.

It is very understandable the pressure that doctors are under in order to clear bed spaces for incoming patients. In my clinical practice i have also felt that pressure from clinicians in order to get a patient up and discharged as soon as possible. However I feel that this should not compromise I patient who is progressing a day or so slower then another, as an early discharge may have many drastic changes on his/her life in the future.

Here is a video of an award winning discharge plan: https://www.youtube.com/watch?v=vQ1TDAH2XeE

Hesselink, G. et al. (2012). Are patients discharged with care? A qualitative study of perceptions and experiences of patients, family members and care providers. BMJ Quality & Safety, 21(1), 39-49.

Psnet.ahrq.gov. (2019). Readmissions and Adverse Events After Discharge | AHRQ Patient Safety Network. [online] Available at: https://psnet.ahrq.gov/primers/primer/11/Readmissions-and-Adverse-Events-After-Discharge [Accessed 26 Sep. 2019].