Multidisciplinary Discharge Planning Team: A Project of the Medicine 2 Service of the Amadora/Sintra Local Health Unit
DOI:
https://doi.org/10.24950/rspmi.2580Palavras-chave:
Patient Care Team, Patient DischargeResumo
The challenge of finding a balance between the inpatient
capacity of the Internal Medicine wards and the growing social needs of the inpatients is a variable in constant tension. The high number of social admissions is a well-known problem and limits the appropriate response to acute admissions. Discharge Planning Teams are multidisciplinary teams of doctors, nurses and social workers who work with all professionals involved in the clinical pathway and discharge planning. The team's working model is based on the early and systematic assessment of all users, using three scales as instruments that constitute the team's initial assessment of the user. The monitoring of several indicators in real-time makes it possible to adjust and improve the assessment process, as well as to monitor gains in terms of care indicators.
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Referências
Roper N, Logan W, Tierney A. Modelo de enfermagem. 3ª ed. Lisboa: McGraw-Hill; 1995.
Mendes FP, Gemito ML, Caldeira EC, Serra IC, Casas-Novas MV. A continuidade de cuidados de saúde na perspetiva dos utentes. Ciênc Saúde Colet. 2017;22:841-53.
Teixeira MI. Planeamento integrado de alta hospitalar nos idosos [dissertação apresentada Faculdade de Ciências Médicas, Universidade Nova de Lisboa]. Lisboa: FCM, UNL; 2012.
Associação Portuguesa dos Administradores Hospitalares. 7ª Edição do Barómetro de Internamentos Sociais. Lisboa: APAH; 2023. [consultado mar 2024] Disponível em: https://apah.pt/wp-content/uploads/2023/06/APAH_7a-Edicao-BIS_Resultados-1.pdf
World Health Organization. WHO Guidelines on Integrated Care for Older People. Geneva: World Health Organization; 2017.
Temido H, Parente F, Borba V H, Santos L, Carvalho A. Internamento em Medicina Interna: Evolução em 20 Anos num Hospital Universitário. Med Interna. 2022;25:275-9. doi: 10.24950/rspmi/original/224/4/2018
Pereira Pinto M, Martins S, Mesquita E, Fernandes L. European Portuguese Version of the Clinical Frailty Scale: Translation, Cultural
Adaptation and Validation Study. Acta Med Port. 2021;34:749-60. doi: 10.20344/amp.14543.
Lains J. Guia para o sistema uniformizado de dados para reabilitação médica, versão para a língua portuguesa. Ed. SMFR/HUC e Research Foundation - State University of New York at Buffalo. New York: SUNW; 1990.
Carvalho H, Espírito Santo MI, Ferreira J. Construction and Validation of Social Work Intervention Complexity Scale in Hospital Care Settings. Br J Soc Work. 2022;52:3740–60. doi: 10.1093/bjsw/bcac103
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Direitos de Autor (c) 2024 Medicina Interna
Este trabalho encontra-se publicado com a Licença Internacional Creative Commons Atribuição 4.0.
Direitos de Autor (c) 2023 Medicina Interna
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