Interdisciplinary discharge planning. A continuing care management model

The author describes how one comprehensive cancer center meets the challenge of providing quality discharge planning. Because discharge planning is an interdisciplinary process, various team members' responsibilities are presented. It is recognized, however, that the primary nurse is most often in the best position to make recommendations related to preparing the patient for discharge. The support of the primary nurse in this area is examined in this article, in more detail, through a formalized program. A tool is included that assists the primary nurse with the discharge planning process. Current legislation and professional standards affecting discharge planning are discussed.