Optimizing Discharge Efficiency through Improved Communication
Authors
Russell, Kristine K.
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- Embargoed until 2026-05-22
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Abstract
Problem & Purpose: In 2023, a large urban academic medical center faced critical hospital overcrowding, with patient occupancy averaging 97%. This led to delays in admissions and operating room cancellations, highlighting the need for improved patient throughput. A 20-bed cardiac surgery progressive care unit internal review revealed a lack of a systematic approach to patient discharges. This quality improvement project aimed to enhance discharge communication within the interdisciplinary care team for adult cardiac surgery patients. An electronic discharge checklist was implemented in Fall 2024 to align team efforts with the hospital’s strategic priorities while ensuring care quality. Methods: Implementation began with comprehensive staff training on the electronic discharge checklist to ensure familiarity and stakeholder engagement. The electronic discharge checklist was activated within 24 hours of admission for all patients. Charge nurses utilized the electronic discharge checklist during morning rounds and afternoon huddles to establish the next-day discharge targets and coordinate team efforts toward achieving key discharge milestones. Results: Following a 15-week implementation period, the cardiac surgery progressive care unit maintained an average daily census of 18.5 patients, 3.2 patients were 'Discharge Ready' during interdisciplinary discharge rounds, utilization of the discharge checklist was 99%, and daily home discharges averaged 1.6 patients. An increase in discharges-before-noon from 7% to 39%, and a reduction in discharge order to discharge time from 240 to 200 minutes, represents a meaningful clinical significance based on benchmarks. Conclusion: Implementing an electronic discharge checklist can positively impact discharge communication and improve discharge times, underscoring the importance of collaborative interdisciplinary approaches to patient flow challenges
