DHM

Hospitalists in the News

Designing a Mt. Zion Discharge Program – Discharge Facilitator and Care Transitions System Utilizing an Interdisciplinary Team Approach
Sumana Kesh

Stephanie Rennke

The Mt. Zion Discharge Program will be designed to focus on key issues around the transitions process at UCSF including patient-centered education, medication management and preparing the patient for discharge. Nurses, pharmacists, hospitalists, social workers and case management will all work together utilizing an interdisciplinary approach towards transitions in care. The program will particularly address the needs of the elderly and underserved patients at Mt. Zion. The goals of the program will be to provide education to patients and staff while promoting a patient-centered approach to medication self-management and safety thus ensuring a safe discharge plan in the hopes of significantly reducing subsequent re-hospitalization rates.