S.B. NO.

2397 (SB2397)
This bill is related to discharge planning. In the beginning of the
document, it talks about how hospitals are required to follow certain
conditions when it comes to discharge planning to receive funding from
federal programs like Medicare and Medicaid. The purpose of this bill is
to improve upon those conditions and include that hospitals must allow
inpatients to 1) designate a caregiver, 2) provide written and oral
instructions to designated caregivers prior to discharge, and 3) notify
designated caregivers prior to a patients discharge or transfer.
Two main terms they explain the definition of for the bill proposal
include caregiver and after-care. The term caregiver is defined
as any individual designated by a patient to provide after-care to the
patient in the patients residence. The term includes, but is not limited
to a relative, spouse, partner, friend, or neighbor who has a significant
relationship with the patient. The term after-care is defined as any
assistance provided by a caregiver to a patient following the patients
discharge from a hospital that is related to the patients condition at
the time of discharge, which includes, but is not limited to assisting
with things like a persons ADLs.
The bill proposes that every hospital must create a written
discharge policy or policies that include the following:
1. Each patient has the opportunity to designate a caregiver,
which will be documented in the patients medical record.
2. Each patient and their designated caregiver have the
opportunity to participate in the discharge planning.
3. Each patient and their designated caregiver have the
opportunity to receive instruction before discharge on the
patients after-care needs.
4. Each patients designated caregiver must be notified of the
patients discharge or transfer and a hospital needs to
make reasonable attempts to notify the patients caregiver
of the patients discharge as soon as practicable. If the
hospital is unable to contact a patients designated
caregiver, the lack of contact shall not interfere with,
delay, or otherwise affect the medical care provided to the
patient or an appropriate discharge of the patient.
In addition, the discharge policy or policies must specify the
designated caregivers contact information for documentation.
Contact information includes the persons name, phone number,
electronic mail address, and address of residence, where available.
In the event that this bill becomes a law, hospitals would need to
create a written discharge policy or policies that include all of the
criteria listed within this bill and if they are found to not be following
any of the specific criteria listed, they will not receive funding from
federal programs, such as Medicare and Medicaid, as mentioned in the

beginning of this post. Due to the fact that nurses are responsible for
implementing discharge planning, they must ensure to follow their
hospitals policy or policies regarding discharge planning, in addition to
any other person in the multidisciplinary team that will also be
involved with performing discharge planning for a patient, such as the
case manager or social worker.
In a study I read about discharge planning, they went to say that,
good discharge planning [helps to] prevent or minimize further
incidents of ill health, which shows that nurses and other people in
the multidisciplinary team need to provide excellent discharge
planning/teaching for patients to ensure that their health conditions
only improve after leaving the hospital (Summerton, 1998). This bill
also goes along with the ethical principles of beneficence and
nonmaleficence because it only promotes good and does not inflict
harm (Cherry & Jacob, 2014). The passing of this bill will only help to
improve the outcome of the patients health when they are discharged
so I think its great if it becomes approved as a law.
References
A Bill For An Act Related To Nursing, SB2397. (2016). Retrieved from
Hawaii State Legislature.
http://www.capitol.hawaii.gov/session2016/bills/SB2397_SD1_.pdf
Cherry, B. & Jacob, S. (2014). Contemporary nursing: Issues, Trends
and Management (6th ed). St. Louis: Elsevier.
Summerton, H. (1998). Clinical management. Discharge planning:
establishing an effective coordination team. British Journal Of Nursing,
7(20), 1263-1267 5p.