Tweet Smears Hospital's Discharge Incentive Campaign

A tweet decrying a Baltimore hospital's effort to speed patient discharges implied that patient safety was being put at risk. How much damage was done to the hospital's reputation remains to be seen.

6 comments on "Tweet Smears Hospital's Discharge Incentive Campaign"
LL (8/30/2013 at 12:38 AM)

I think the real issue is the fact that the nurse tweeted about it. Nothing wrong with the program and I'm sure there was no ill-will. But, from a PR perspective, sending the tweet was a fail. You never want to put your employer in a reactionary & defensive position. Especially when the intent was meant to improve, not harm. I'm not sure I understand why some people continue to tweet exactly what they are thinking. And you definitely don't want to do that when it relates to your job.
Christine Pittman (8/29/2013 at 7:26 PM)

I don't agree with an employee of any institution voicing a concern over Twitter, especially in a manner that leaves out the facts. Having said that, we should consider the crucial information that is exchanged during the discharge process. The nurse, pharmacy and case management staff must interpret and respond to the provider's discharge orders. Those roles are responsible for giving the patient and family their best opportunity to succeed in the post hospitalization period. Just as the spokesperson said, Nursing staff has a lot to do to finalize paperwork, communicate discharge instructions to the patients and family, arrange for transportation, find the patients' belongings, and continue to care for other patients." In addition, there may be prescritions that just showed up to be filled, follow up appointments to be made, discrepancies to be resolved, etc. This is not McDonalds. We have to do the right thing and make certain the patient is set up for positive outcomes.
Nursenat67 (8/29/2013 at 3:07 PM)

Sadly, there are some nurses who "lolly gag" because they don't want to get the time consuming admission. All discharges must have a Physician's order and that is up to his or her medical judgement.
Lisa Corcoran (8/29/2013 at 2:53 PM)

I wonder if she faced any disciplinary actions for the tweet. She must have known she was twisting the truth. All nurses know that it's the physicians who write the discharge order.
Michelle RN (8/29/2013 at 2:34 PM)

The flyer does not say the units and nurse will be rewarded for discharging patients within one hour of the discharge order being written. It says "by noon." In my experience attending physicians tell the patients on morning rounds "you are going home today" and then the nurse is left to pester the doctor and/or residents until they eventually write a discharge order, which is often not done until late afternoon. Often this is because the medical team wants to make sure the patient's final lab results are acceptable, or that the patient has transportation set up to travel safely home. Many family members work so that a pre-noon discharge means someone has to leave work to pick up the patient with short notice. It is the pressure to do this before noon that makes it feel rushed and unsafe for all.
MightyCasey (8/29/2013 at 2:17 PM)

A closer look at that Twitter profile shows that Nurse Rachel is more interested in tweeting to/about the Kardashians and Donald Trump than she is in posting healthcare info, so I'm suspicious of her RN status right there. A larger issue, and one that Sinai is trying to address, is the disconnect between healthcare's stated interest in improving patient UX and engagement while simultaneously partying like it's 1975 when it comes to using tech to drive that UX. Paul Levy put up a great post this week about that very issue ( - if he's frustrated, imagine how any other plain ol' patient might be. Nurse Rachel has done no one any favors by taking to the Twitters with specious commentary. Props to Sinai for trying to spin the story, I'd advise them to read Paul Levy's post and give it more attention than they've given Rachel Amanda ...


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