Hospitals face difficulty in transitioning patients to post-acute care, report finds

Well-intentioned healthcare providers and patients face significant challenges when finding the post-acute care facility best suited to their needs, according to two reports released by United Hospital Fund.

The reports are the next two installments in the fund's four-part "Difficult Decisions" series, based on a yearlong inquiry into post-hospital care.

The first report is based on discussions with administrators and frontline staff at eight hospitals and administrators from five nursing homes in the New York area.

A hospital staff's conscientious efforts are frequently hindered by efficiency pressures, insurance constraints, authorization delays and regulations that limit the assistance they can give patients and family caregivers during care transitions, the authors found.

"Hospital staff members are often under immense pressure to minimize the length of hospital stays while managing a complex process involving the need to align multiple stakeholders around the discharge plan," said report author Pooja Kothari, RN. "The unfortunate reality is that the best solution may not be possible when high-quality, post-acute care facilities have few available beds."

The second report is based on discussions with patients and family caregivers about their experience selecting a skilled nursing facility during hospital discharge planning. The authors found patients and their families felt rushed and reported having little say when deciding on a post-acute care facility.

"We heard vivid stories from our participants about the limited choices they felt they had, the lack of information about the quality of care at different facilities, and what they perceived as the failure of hospital staff to prepare them for the experience of being in a nursing facility, not a hospital," said report author Carol Levine. "In the end, location and access to transportation were often the pivotal factors in a patient's choice."

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