Influencing Discharge Efficiency: Addressing Interdisciplinary Communication, Transportation, and COVID-19 as Barriers

Purpose: At one tertiary, academic medical center, two general medicine units averaged 94% and 97% occupancy causing strain on patient throughput. This project was implemented at these two comparable general medicine units, totaling 64 beds. On each of these units, Pareto analyses on causal factors related to discharge order to exit time (DOTE) were performed. DOTE was defined as the period in minutes from when a provider orders a discharge to when the patient actually exits a room. Prime DOTE reduction opportunities were elicited that highlighted the need to address coordination of hospital discharge transportation; that is, arriving family members averaged 120 and 129 min for the two units, and medicars and ambulances averaged 122 and 156 min, which fell above the established 90-min overall strategic DOTE goal. Coordinating efficient discharges decreases the likelihood of hospital bottlenecking and improves patient satisfaction. Case Management Setting: The health care team is composed of physician and provider services, nursing, and case management, as well as the patient and family. Team-focused interventions aimed at reducing DOTE included leveraging interdisciplinary communication technology and messaging for efficiency and accuracy within the health care team and proactive scheduling of hospital discharge transportation arrival. Process objectives measured included percentage of the health care team educated and utilization of the discharge suite. Outcome ob...
Source: Professional Case Management - Category: Health Management Tags: Articles Source Type: research