The Effectiveness of Community Health Team (CHT)-Inpatient Ward-Agency of Integrated Care (AIC) / Tripartite Case Discussion in Developing Care Plans to Aid Transition from Hospital to Home
31 December 2021
Project Categories
Care Continuum
Platform
Singapore Health Biomedical Congress
Cluster
Agency for Integrated Care - Intermediate and Long Term Care
National Healthcare Group
Evaluate the effectiveness of tripartite case discussion in formulating a collaborative care plan for patient discharge. Tripartite case discussions improve discharge planning and resource utilization, enabling safe transitions from hospital to home.
Year Submitted: 2021
Published Date: 31 December 2021
Tags: Care Continuum, Preventive Care, Community Health, Intermediate and Long Term Care ＆ Community Care, Home Care, Right-Siting
About this Content
Aims
Evaluate the effectiveness of tripartite case discussion in formulating a collaborative care plan for patient discharge.
Background
Fragmented discharge care planning negatively impacts care transitions; tripartite case discussions improve outcomes.
Methods
Retrospective descriptive study involving inpatients with complex discharge issues from four acute care wards. Data analyzed on healthcare utilization pre and post-intervention.
Results
Reduced hospital resources usage; admissions dropped from 365 (pre-90 days) to 146 (post-90 days); referrals to appropriate community services increased.
Conclusion
Tripartite case discussions improve discharge planning and resource utilization, enabling safe transitions from hospital to home.
Lessons Learnt
Collaborative care plans improve transitions; knowledge of community resources is crucial for healthcare teams.
Additional Information
Bronze Award (SHBC Best Poster Award - Nursing) in Singapore Health & Biomedical Congress (SHBC) 2021.
Keywords
Care Transition, Tripartite Case Discussion, Resource Optimization
Innovators' Details
Innovators' Details
Healthcare Cluster(s) | National Healthcare Group, Agency for Integrated Care - Intermediate and Long Term Care |
Organization(s) Involved | Tan Tock Seng Hospital |
Platform(s) | Singapore Health Biomedical Congress |
Healthcare Professional Group(s) | Healthcare Administration, Nursing |
Applicable Specialty or Discipline | General Medicine, Healthcare Administrators |
Project Lead(s) | Lau Ling Li Eileen |
Project Member(s) | Tan Zong Rui |
Connect with this contributor!
Lau Ling Li Eileen - eileen_ll_lau@ttsh.com.sg