The aim of patient management is to improve individualised patient care. All processes from admission to discharge of a patient should be coordinated in such a way that seamless and optimal care is possible. We work closely with all professional groups involved in patient care. There is also close contact with our social services and family care. Patient management has the task of optimally coordinating all individual patient care. For example, they organise bed occupancy and coordinate discharge appointments. Patient satisfaction and optimum medical, nursing and psychosocial care always take centre stage.

• Advice on outpatient assistance, such as care insurance, care applications, care aids, local outpatient assistance services and referral to outpatient care services
• Advice and support with transfers to partial and full inpatient facilities
• Counselling and application for follow-up rehabilitation measures
• Social law advice on health care proxies, guardianship law and severe disability
• Applying for legal guardianship
• Referral and advice on self-help groups, advice centres and authorities

A particular focus is the transfer of care to outpatient and inpatient care facilities, including short-term care. Close co-operation with relatives is sought here.

Patients are discharged from hospital at the end of their hospital treatment. In certain cases, however, further support is required after the end of hospital treatment in order to secure the treatment outcome. Appropriate follow-up care can include, for example, medical or nursing care that is provided on an outpatient basis or in inpatient rehabilitation or care facilities. However, this follow-up care can also include, for example, making appointments with doctors and support in applying for benefits from the health or care insurance fund.

The so-called discharge management framework agreement came into force on 1 October 2017 to ensure that all patients who have a corresponding need for care are supported in this regard.
Irrespective of this, the GFO hospitals have also provided their patients with the best possible care in the past with regard to discharge and the transition to the post-inpatient phase. In order to implement the requirements of the now legally binding EM, we have developed guidelines throughout the organisation to ensure that your discharge and that of your relatives is as smooth as possible in the future.
The hospital is legally obliged to prepare for the discharge of patients from hospital. The aim of discharge management is to organise seamless follow-up care for patients. To this end, the hospital determines whether and which medical or nursing measures are required following hospital treatment and initiates these measures during the inpatient stay. Various professional groups, in particular doctors, nursing staff and social services (care transfer) work together on an interdisciplinary basis to achieve this.
Patients are informed and counselled by the hospital about all discharge management measures. All planned measures are coordinated with them. If the patients so wish, their relatives or carers are consulted for information and advice.