Stakeholders and Approval

Stakeholder/Committee/Special Group Reporting and Approval Process

A stakeholder is a person whose perspective and/or role is critical to a process. For the discharge process there are many stakeholders and it is important to ensure many of those are on your team.

Identifying and including stakeholders in your project team, from the beginning, is critical for success. In addition, you should identify existing committees or teams in the hospital that are already working to improve care transitions and determine how to link to or integrate existing efforts.

Team membership may include

1. Clinical nursing staff
2. Physicians involved in the discharge process (including residents if present at your hospital)
3. Primary care physicians/ Geriatricians/ follow-up specialty physicians
4. Physicians who care for patients at subacute and acute rehabilitation facilities
5. Allied health professionals (nurse-practitioners and physician assistants)
6. Social work
7. Case management
8. Pharmacists
9. Medical Records department
10. Hospital informatics
11. Home care referral coordinator
12. Data analyst
13. Nutrition/dietary
14. Emergency department (paramedics/ambulance drivers) — has proven valuable for hospital-to-SNF transfers
15. Patients who have been hospitalized at your institution in the past
16. Family/caregiver

At a minimum, you should include the individuals with roles described in bold in your core working group.

Because there typically is tremendous variation in how a hospital discharge process is handled, you should be certain to include individuals who are invested in and see the value standardizing the process. The care transition for older adults also has dimensions that may require the expertise of individuals who work regularly with them. Also, consider including patients/families as content experts on your team, as they have a perspective that is unique and critical to all the efforts of your team.

Each hospital team must determine the skills and team members essential to the development and implementation of the care transition initiative. Ad hoc members, or people whose input will be required only periodically should also be considered. Examples may include representatives from billing/coding services and finance. View a sample form to help you (A) identify key stakeholders, committees and special groups and (B) clarify the reporting structure and approval process for your interventions and resources needed.