Streamlining Ostomy Teaching and Discharge Planning to Answer the Decrease in Length of Stay Trend

Historically ostomates have had longer hospitalizations in which to receive care and teaching of their newly created ostomies. Discharge planning would begin once patient was admitted and WOC nurses had time to provide teaching with the patient and families.   The advancement of surgical procedures, and enhanced recovery periods have decreased a patient’s length of stay considerably.  It is not uncommon for a patient to have surgery on Friday and be discharged to home that Sunday. 

To address the multitude of post operative needs, a workflow was devised to streamline the teaching and discharge planning of this population of patients.  A multidisciplinary approach was coordinated by a Certified Wound Ostomy Continence Nurse to devise a work flow to encompass preoperative teaching, stoma marking, discharge planning and identification of patients DME prior to surgery and organization of discharge with home health care support and supply procurement on post operative day one.  Patient care services that are comprised of Social Workers and Case Managers were engaged in addressing needs prior to surgery. Surgical providers are involved in coordinating outpatient follow up to insure each ostomy patient is progressing in care and performing at optimal level of independency with in days of discharge.   

The workflow was developed to move what use to be extensive training and coordination from the post operative period to pre operative period.  Discharge planning is beginning before the patient is even admitted to insure a continuity of care as they quickly move through their hospitalization.