Hospital clinicians’ evaluation and decision-making regarding which patients are discharged to a skilled nursing facility (SNF) “may be characterized as rushed, without a clear system or framework,” according to a clinical investigation published by the Journal of the American Geriatrics Society.
Due to increased accountability placed on both settings for the outcomes of individuals who are transferred between hospitals and skilled care facilities, the investigation concluded that there is an urgent need for improvement in the evaluation and decision-making process when discharging patients/residents.
The investigation studied how hospital-based clinicians evaluate older adults in the hospital, along with the decision-making process for determining which individuals get transferred to a SNF. Clinicians interviewed from three different hospitals for the investigation reported that they feel pressure to expedite evaluations and decisions relating to patient discharge, referring to the use of SNFs as a “safety net for older adults being discharged from the hospital.”
Authors of the investigation found that the hospital-based clinicians interviewed lacked knowledge of the care practices, quality, and patient outcomes in a SNF, leading to no standardized evaluation process or clear primary decision-maker. Further, the investigation attributed varying clinician recommendations to clinicians’ potential lack of familiarity with SNFs in their area, along with the fact that there is not a “validated tool” that reliably predicts the benefit of a SNF stay.