Mass. hospital improves ER flow by prioritizing morning discharges

After staff noticed structural inefficiencies in the emergency department, a Massachusetts hospital improved its flow and safety by prioritizing discharge.

Lahey Hospital and Medical Center in Burlington developed a multidisciplinary task force to address ED compression through an early morning discharge initiative, which had a goal of discharging 20 patients by 10 a.m. across the facility, according to Hospitals & Health Networks. Despite its clear-cut goal, there were numerous barriers, including an existing culture of late-afternoon discharges within the hospital; the communications gap among the various staff involved in the discharge process; and lack of incentive among staff to prioritize discharge among providers with numerous other items on their itineraries.

To address these issues and successfully implement the program, Lahey’s task force developed several strategies, including:

  • Regular updates about progress and best practices for frontline staff
  • Promoting multidisciplinary rounds to strengthen communication throughout the continuum of care
  • Incentivizing discharge by providing gift cards for nurses who led the unit in discharges by 10 a.m.
  • Enlisting the help of family members who patients rely on for transportation by offering free parking and breakfast vouchers
  • Share results with floor units and department heads to promote data transparency and accountability
  • Deploying “social marketing,” making sure to communicate that the initiative aims for improved patient safety and satisfaction rather than merely freeing up beds

The hospital has yet to fully achieve this goal but has still made numerous strides, according to the article. It has reduced the overall median discharge time by nearly an hour throughout the hospital, and staff acknowledge the need for broader cultural change throughout the facility to realize the full goal, according to H&HN.

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