Discharge Planning at Valley
Discharge planning should begin as soon as possible after your admission to the hospital. If your hospital stay is planned, discharge planning can begin even before admission. Discharge planning involves:
- Assessing the patient’s psychological, social and cultural needs
- Developing a plan of care after hospitalization
- Arranging for provision of services
During your stay at The Valley Hospital, you will be cared for by a team of doctors, nurses, and other skilled professionals. An important member of this team is your case manager. Every patient admitted to The Valley Hospital has a case manager who can assess and plan for your needs when you leave the hospital. Depending on your needs, your discharge planning may also involve the services of social workers and Valley Home Care Coordinators.
- Case managers are registered Nurses
- Case Managers work closely with patients, family members, and physicians to ensure patients receive the best care possible.
- Case managers visit patients during their stay in collaboration with a patient’s physician and family to evaluate needs and make referrals for post-hospital care.
- Case Managers provide clinical information regarding the patient’s hospitalization to the patient’s insurance company upon their request.
The medical social workers at The Valley Hospital are licensed, masters-prepared professional with specialized knowledge, education and experience in the fields of human behavior, psychology and problem solving. Medical social workers meet with patients, and their families or significant others to discuss concerns regarding the patient’s illness, hospitalization, and/or return home. The medical social workers at Valley provide referrals and coordinates services to ensure patients receve continuum of care. Services include:
- Counseling and crisis intervention
- Facilitating adjustment to hospitalization and/or illness
- Educating and coordinating planning for long term care
- Providing information on resources
- Networking with community, county, and federal services
- Dealing with end-of-life issues
- Referring to legal services
- Coordinating discharge plans in conjunction with case managers
- Facilitating support groups.
Your doctor decides when you are ready to leave the hospital. Please talk to your family early in your hospital stay about an arrangement for transportation, so you are prepared when your discharge date is set. Care after discharge from the Valley Hospital may include transferring you to a rehabilitation center or skilled nursing facility, coordinating home care or hospice, and arranging for medical equipment.
Services can be arranged by members of your healthcare team if ordered by a physician and criteria are met and approved by your insurance coverage as not all services are covered by insurance.