End Discharges Forever.

It's not a secret that humans respond to advertising. We buy in to aspirations and ideas which appeal to our needs to feel good about ourselves.  We also respond to the labels applied to sell concepts. 

"New and improved" is a primer to say "this is better and you want the best". 
 "Cost effective" or "Good value" carries positive connotations whereas "cheap" brings associations of "cheap and tacky" "cheap and nasty". 
Branding is a dark art on its own and fraught with danger, sometimes it works well, no longer a "dodgy Datsun" but a "Nice Nissan", the scandals of Anderson Consulting do not linger around the Accenture brand. 

So look at the health service and tell me what's a discharge?  

Usually unpleasant, better out than in?  

Painful, nauseating, puss filled?  

No actually, they are our customer, our treasure, our reason for being.

We should pass them on like heirlooms, like eggs in baskets. 

Separate responsibility from location. 

one quick and easy way to end discharges would be to only have transfers of care. Six years ago I blogged about discharging from primary care, into hospital. That was wrong, but said as away of shifting a paradigm it can open the door to change. 

Provision of teams who take complex patients home,establish viability BEFORE transfer to primary care offers an end to re- admissions. 

Similarly hospital rounds carried out by hospitalists who collect the inpatient data, enter it on EMIS web, send prescriptions via electronic prescribing to community pharmacy who actually deliver will end discharge letters, avoid waiting for letters and receive the patient back into the arms of primary care, whilst still in hospital. 



Discharge is over if you want it.