involving an interprofessional team to provide a thorough assessment, establishing
continuous communication with the patient and caregivers; working toward shared
decision-making and self-management; and liaising with health and social services,
particularly primary care, in the community. In Japan, hospitals are obligated to
outline medical fees, but the format and content of the documentation are not
stipulated.
The MHLW commissioned the “Comprehensive Research on Electronic Formats
and Standardization of Documents Prepared by Medical Institutions” (Yamamoto,
2009) and the Medical Information System Development Center to create a standard
for medical care. In addition, we are working on the standardization of terms
necessary for records and nursing records. Moreover, NANDA International
(NANDA-I) diagnoses books, Nursing Interventions Classification (NIC) books,
Nursing Outcomes Classification (NOC) books have been translated into Japanese
and installed in Electronic Medical Information Systems. However, the MHLW has
not created a standard discharge plan, and such plans are created only by individual
prefectures, cities, and hospitals.
8.3 What Are the Issues Surrounding the Standardized
Discharge Summary?
The Tokyo Metropolitan Bureau of Health and Welfare in Japan published the
“Tokyo Metropolitan Discharge Support Manual” (Tokyo Bureau of Health and
Welfare, 2016). In addition, the Agency for Healthcare Research and Quality in the
USA created a clinical tool, IDEAL—Discharge Planning Overview, Process, and
Checklist—which provides key elements necessary to create a discharge summary
(U.S. Agency for Healthcare Research and Quality, 2017).
8.4 Key Elements of IDEAL Discharge Planning
IDEAL is an abbreviation for Include, Discuss, Educate, Assess, and Listen.
Include the patient and family as full partners in the discharge planning process.
Discuss the following five key areas with the patient and family members, to
prevent problems at home:
1. Describe what life at home will be like.
2. Review medications.
3. Highlight warning signs and problems.
4. Explain the test results.
5. Make follow-up appointments.
Educate the patient and family members about the patient’s condition, the
discharge process, and next steps in plain language throughout the hospital stay.
Current Status and Issues with Japan’s Community-Based Integrated Care System:. . .
167
continuous communication with the patient and caregivers; working toward shared
decision-making and self-management; and liaising with health and social services,
particularly primary care, in the community. In Japan, hospitals are obligated to
outline medical fees, but the format and content of the documentation are not
stipulated.
The MHLW commissioned the “Comprehensive Research on Electronic Formats
and Standardization of Documents Prepared by Medical Institutions” (Yamamoto,
2009) and the Medical Information System Development Center to create a standard
for medical care. In addition, we are working on the standardization of terms
necessary for records and nursing records. Moreover, NANDA International
(NANDA-I) diagnoses books, Nursing Interventions Classification (NIC) books,
Nursing Outcomes Classification (NOC) books have been translated into Japanese
and installed in Electronic Medical Information Systems. However, the MHLW has
not created a standard discharge plan, and such plans are created only by individual
prefectures, cities, and hospitals.
8.3 What Are the Issues Surrounding the Standardized
Discharge Summary?
The Tokyo Metropolitan Bureau of Health and Welfare in Japan published the
“Tokyo Metropolitan Discharge Support Manual” (Tokyo Bureau of Health and
Welfare, 2016). In addition, the Agency for Healthcare Research and Quality in the
USA created a clinical tool, IDEAL—Discharge Planning Overview, Process, and
Checklist—which provides key elements necessary to create a discharge summary
(U.S. Agency for Healthcare Research and Quality, 2017).
8.4 Key Elements of IDEAL Discharge Planning
IDEAL is an abbreviation for Include, Discuss, Educate, Assess, and Listen.
Include the patient and family as full partners in the discharge planning process.
Discuss the following five key areas with the patient and family members, to
prevent problems at home:
1. Describe what life at home will be like.
2. Review medications.
3. Highlight warning signs and problems.
4. Explain the test results.
5. Make follow-up appointments.
Educate the patient and family members about the patient’s condition, the
discharge process, and next steps in plain language throughout the hospital stay.
Current Status and Issues with Japan’s Community-Based Integrated Care System:. . .
167