Quote:
Originally Posted by dbussone
As I noted previously, once your attending physician has signed your discharge orders, and your nurse has provided you with any prescriptions, discharge instructions, and follow-up appointments, you are free to leave. A hospital physician (Hospitalist) has no bearing if he was not involved in your care. If you are delayed because of a hospitalist, that is a rule of that hospital - and not a common practice. Ask to speak to the nurse manager or supervisor for an explanation. If you get no satisfaction ask for the case manager to whom you are assigned. Still no satisfaction, go (have your advocate/spouse/friend go) to administration and raise a ruckus. A decently run hospital wants to have you leave as soon as your physician says you can. A decently run hospital has case management/discharge planning working on your discharge plan as soon as you are admitted. A hospital with decent management wants to stop incurring costs on your behalf as soon as they can. (For a patient to remain in a hospital hours beyond a reasonable discharge time costs a lot. Meals, perhaps continuing medications, nursing time - all are wasted.)
If this was a practice in a hospital under my responsibility it would not last for long. If it is happening in a hospital you use, my guess is that the hospital is using this process to be sure all the insurance "I"s are dotted and "t"s are crossed. Case management and nursing should be checking things from the time of admission, and reminding physicians to write orders, etc. that way you can leave at an appropriate time. My opinion is that your hospital has a funky discharge process in place - and it's not the nurses fault.
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I LOVE YOUR RESPONSE !! But let me tell you what I was told. First, I recently was told that most hospitals have a Hospitalist. I was also told the same Hospitalist serves both the Villages hospital and the Leesburg hospital. This information came from a board member who did say they were working on the problem of delayed discharges. In my case, my nurse said she had prepared all the necessary paperwork and only that remaining was the release signature of the Hospital doctor. After many hours, I did discuss my plight with the head nurse who told me that if I chose to leave without the hospital doctor's release, there was a chance Medicare would refuse to participate in the cost of my stay. This concerned me enough that I with street clothing on, waited nearly 9 hours for the final signature.
