This week has been very disorganized week full of complex patients, mtgs and unpredictable patients.
Lots of things have impacted, including
a)Patients have been ready earlier than expected e.g. elective patients.
b)Patients have been discharged earlier from PT (? new rotational PT)
c)I've had to pick up patients from a colleague that have not been seen
d)Electives haven't been seen pre-admission
e)New education sessions and inservice this month/year cutting down clinical time
I've realized its just a busy time and its a time for complex patients also. But i have definitely recognized this impact of organization and time management on effectively planning for discharges. This increases the chance of clear communication between team members and has a knock on affect in terms of working as a team.
How could I have changed things for the better?
Again better communication between all of us could have helped with organisation and time management.
I think one of the barriers for disharge planning on the ortho ward is that often it isnt appropriate for the OT to assess until the patient is mobile or neally ready for discharge from PT, and by that stage we have reviewed the notes and know a little about the patient then have to go in and assess for discharge and our input is much quicker. I think it would be helpful if we communicate with the physios to allow us to better plan when we are going to see patients so we know its an appropriate time (i.e. their mobility is improving - or when they are going to take them on the stairs)then we dotn have the problem of rushing at last minute for disharge planning.
I observed a case yesterday, where the PT had discharged a patient a bilat THJR, and my OT colleague was not happy for him to be discharged that day because when she assessed his transfers he was not safe. But because PT had discharged the staff were thinking that he was safe for discharge. A classic case of the power PT has on the ward. However, my collegue stood her ground and the ACNM listenned and delayed discharge till the following day (even though she wasnt happy about it).
For out elect hips especialy it would make a smoother discharge for the PT/OT to agree on a discharge date and talk about when they think its appropriate from both OT/PT view - working together and communicating..