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Implementing Inter-professional Discharge Planning to Reduce Time for Patient Discharge

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2022-05
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Discharge Planning to Reduce Time for Patient Discharge
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Abstract

Problem: Discharging patients from the hospital can be a complicated process that comes with challenges. Hospital data from the telemetry/ medical-surgical unit in August 2021 identified an average time of 419 minutes from the time of written discharge to the actual time the patient leaves the unit, and the goal time is 120 minutes. This delay has also affected emergency department length of stay as the average number in the hospital is approaching 4 hours. Purpose: To implement and evaluate the n-by-T strategy and interprofessional discharge planning in a telemetry/ medical-surgical unit to reduce the time between eligibility for discharge and time of discharge. Methods: The quality improvement project involves utilizing a discharge checklist with the n-by-T strategy during interprofessional rounds to safely schedule a number of patients (n) for the same or next day discharge by a goal time (T) for the patients on a 51-bed telemetry/ medical-surgical unit. The evaluation includes the use of the discharge checklist during discharge rounds, the average speed of the discharge process (difference in time of eligibility for discharge and time of discharge), the average time of discharges (this is the time the patient leaves the unit), the length of stay, the unit’s 7-day and 30-day readmission rates. Results: In August 2021 pre-implementation, the speed of discharge process was 419 minutes, and the length of stay was 4.33 days. Post implementation, the average speed of discharge was 628 minutes in October, 302 minutes in November, and 261 minutes in December. The average length of stay post-implementation was 4.04 days, 3.69 days, and 3.98 days, for October, November, and December, respectively. Conclusions: Implementation of interprofessional discharge planning and the n-by-T strategy was associated with decreased length of stay, and improved discharge speed.

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