Here we'll get into the details of care planning meetings in order to help you understand the process and how it aids in ensuring high-quality, coordinated care after hospital discharge.
A care planning meeting is a planning session that is typically organized by a hospital social worker, discharge planner, or case manager. The purpose for these meetings is to assess the condition and needs of the patient in order to plan a smooth, safe transition away from the acute care setting of the hospital at discharge. Ideally, everyone who has been involved with the care of the patient will attend, be represented, or provide input, including physicians, surgeons, nursing staff, and therapists, as well as social workers and/or discharge planners or case managers. The patient or their representative is included in these meetings, and family members or caretakers may be asked to participate as well.
The goal of a care planning meeting is to evaluate and discuss what is in the best interests of the patient upon discharge and plan the arrangements and resources necessary to ensure that those needs are met. Among the issues typically discussed is whether or not the patient is medically fit to be discharged to home, and if so, what sort of outpatient follow-up care and/or therapy will be necessary and whether there will be adequate access to care, medications and transportation to appointments.
If the team feels that the patient is not well-prepared for a home discharge, requiring additional inpatient care to ensure successful recovery and rehabilitation, the reasons for that advice will be explained in detail. Options and resources for securing sub-acute care will be also discussed, such as short-term inpatient rehabilitation programs in your area or the availability of longer-term care in a skilled nursing facility.
Final decisions are always made by the patient or, if they are unable, designated family members or other representatives, but the professional advice and resources shared at these meetings can give them the solid, medically-informed foundation they need to ensure that those decisions are solid ones. So if a care planning meeting is in the works for you or your loved one, active participation is definitely advisable.
These meetings are a very important part of effective discharge planning, working to formulate a comprehensive plan to provide the best possible opportunity for a sound, healthy recovery.