Standardized discharge improves hospital efficiency

care team

Healthcare providers can improve their efficiency and potentially improve patient satisfaction through a standardized discharge strategy, according to a study published in the American Journal of Managed Care.

Researchers conducted a retrospective study of outcomes in a tertiary care center at Geisinger Health System’s Department of General Surgery, examining data from 1,005 adult patients who visited for elective inpatient colorectal surgery between 2007 and 2014. In 2011, the provider implemented a discharge navigation program with five steps:

  1. A post-morning rounds meeting between navigators and house staffs to identify patients preparing for discharge
  2. Review of those patients’ medications (poor medication reconciliation is a major driver of post-discharge problems)
  3. Confirmation of their prescriptions
  4. Education on wound care
  5. Follow-up appointment confirmation

Researchers divided patients into three cohorts: 636 patients treated from January 2007 to September 2011, before the program as implemented; 220 patients treated from September 2011 to May 2013, when the program was implemented with only one patient navigator; and 149 patients treated from May 2013 to May 2014, after a second navigator was added. They found that between the first and second phases, the percentage of patients discharged from the hospitals by 2:00 p.m. increased nearly eight points. Moreover, they found that the median discharge time was 1:45 p.m. for the first cohort but 1:15 p.m. for the second two cohorts.

“The next step includes determining the relationship between the time discharge orders are written and its effect on discharge lag time. The lag time is defined as the time the patient physically leaves the hospital minus the time the discharge order was written,” the authors wrote. “We also plan to look at the effect of the program on venous thromboembolism prophylaxis and errors in medication reconciliation.”

Research has shown the most successful discharge programs have the same attention to detail as part of the discharge process as they do for the admissions process, FierceHealthcare previously reported.

- read the study