Unfortunately, too many people who've needed to schedule medical appointments have had the frustrating experience of calling, only to be told the next available appointment is weeks or months away.
I think many people are surprised to find that coordinating appointments can also be challenging for the inpatient psychiatric hospital team.
On one hand, the inpatient team has staff available that are professionals at coordinating care. In addition, the various expertise available, combined with daily rounding, means that the hospital can advocate for the type of care most appropriate for a patient. Finally, the argument can be made that the patient's needs are urgent, as they are leaving hospital-level stabilization, but will likely need additional support to make a full recovery.
However, sometimes the setting of the hospital itself can be a double-edged sword. For instance, limited inpatient bed numbers combined with the goal of stabilization means that every patient on the unit is likely going to have a shorter stay. As a result, some hospitals can have a high patient turnover rate, and each patient will still need appropriate follow-up care arranged. Additionally, many psychiatric hospitals are free-standing, and have very little leverage over the follow-up appointments available via other organizations. Finally, insurance constraints need to be navigated.
Also, ideally treatment plans are built in collaboration with the patient. Some patients may need help with transportation, and so care needs to be coordinated with the transportation provider in mind. Or perhaps they receive one type of medical care at a particular healthcare site, and they would ideally like any mental health care providers to be located in the same building or within the same healthcare system. These patient-centered concerns can be discussed during daily rounds or team appointments, so that ideally everyone is working towards shared discharge goals.
Despite the above challenges, hospital teams very typically need to coordinate the following for every patient:
A medication management provider
That the patient will be able to fill any recommended prescriptions
A therapy provider
Appointments for any other medical issues discovered or treated during their psychiatric hospitalization
To reach these goals, inpatient teams usually start general discharge planning for a patient soon after the patient is admitted. I.e., a patient may have an initial day to get settled, but on the first full rounding day, the team will begin investigating what care options are available in the community.
The discharge planning process starts early in order to be as prepared as possible for when the patient is actually ready to be transitioned to a lower level of care. Not everything can be planned ahead of time, and there are frequently unexpected surprises that need to be addressed closer to discharge day. But overall, planning early is usually much more beneficial to the patient.
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