“Our intervention enhanced internal medicine residents’ awareness of key components of successful post-discharge care,” wrote lead author Megan Young, MD, assistant professor of medicine at BUSM, and colleagues. “These components include an emphasis on communication among providers, patients and their caregiver; the importance of ensuring discharge plans are feasible given patients’ individual needs and home lives; the value of a multi-disciplinary approach to patient care that includes consideration of psycho-social as well as physical needs; and, albeit to a lesser extent, the benefits of medication reconciliation.”
A group of 39 second- and third-year internal medicine residents from Boston Medical Center (BMC) participated in post-hospital discharge home visits with elderly patients. The visits lasted between 60 and 90 minutes. The residents were able to review and determine the efficacy of the patient’s discharge plan, while identifying the effectiveness of different aspects.