What Is Discharge Planning and Who does the Utilization Review?

Healthcare cannot exist without discharge planning.

Discharge planning serves to ease the transition process from hospital to home care.

The physicians, bedside nurses, specialties, and other members of the healthcare team work together to ease the discharge process.

For optimal discharge planning, professionals review the physical, psychosocial, and financial needs of the patients.

They plan according to current home conditions and prevent any delays or barriers toward recovery.

Some patients need continuous care at home, and discharge planner manages the admission to specialized nursing facilities, rehab facilities, or assisted-living organizations.

Nurses who examine the cost efficiency of healthcare services while providing quality care are the utilization of review nurses.

their task is to review all patient’s medical records and to make sure that the patient goes under all necessary procedures and none of the unnecessary or costly diagnostic tests.

Also, utilization review nurses assist patients on issues with their individual benefits plans.

It can include private insurance, Medicare, or Medicaid.

What is the Connection between Discharge Planning, Utilization Review, and Case Management Nursing?

In some aspects, discharge planning and utilization review overlap with case management.

Similar to discharge planners, case management nurses work with other healthcare professions to provide the best care.

Case management is a wider, and umbrella term for mentioned services.

Discharge planners focus on hospital-home transition, while case management nurse focus on optimizing the entire patient’s hospitalization process.

Some case managers are in charge of the utilization review, and they need to make sure that patients are not over-utilizing resources they don’t need.

In short terms, case management is a wide term, which includes discharge planning and utilization review.

Despite being very different, case management, discharge planning, or others are similar roles and overlap.

Related Quetions

Leave a Comment

Find a Program