Postoperative Recovery and Survivorship After Acute Hospitalization for Serious Life-Limiting Illness

Abstract

This article provides a road map for discharge planning of adult patients with serious life-limiting illnesses. The need for early and guided conversations with specific prompts is offered to assist in the transition of care process. Transparent, patient-centered interactions are emphasized throughout with an acknowledgment that this type of direct, interpersonal communication may challenge a clinical team's typical mode of operation. Nevertheless, when done well, this approach can lead to better outcomes for everyone involved. This framework for discharge planning has led to greater patient and family satisfaction, lower mortality, reduced societal costs, and fewer instances of hospital readmission.

Keywords: Communications; Discharge planning; Life-altering; Palliative care; Patient-centered care; Serious life-limiting.