Discharge Planning in the Hospital

In this Children’s Hospital, there was a dysfunctional system for discharging patients that were medically ready to be released, only 30% of patients were released < 4 hrs of them being identified as medically ready to leave

Case Study Details

80% discharges done in less than 4 hrs when patient is determined to be medically ready to leave

  • freed up bed space to recover 4 beds per year
  • 332 additional patients can be supported with the savings

Reworking and retraining the staff on efficent discharge procedures were implemented

  • Developed process and procedures built around evidence based best practices, teamwork, and communications
  • Used simulation to train staff on new discharge procedures

2 hrs of non-clinical duty for each learner

  • optimization of the discharge procedure
  • needs coordination with billing

< 1 year (2007)

Clinical and Administrative resources to review best practices literature and adjust for internal constraints

  • space to conduct simulation training
  • properly trained staff to support training initiative
  • learner time to train away from clinical duties
  • 30% discharges done in less than 4 hrs
  • Continued in-efficiency in the discharge of patients
  • atient Length of Stay longer for no medical reason
  • reduced capacity by 332 patients due to inefficiencies
  • loss of potential revenue from the 332 prospective patients, ~ $11.47 million/year

Decision Maker Talking Points

  • Be able to treat an additional 331 patients per year in the Hospital
  • Potential Revenue of an additional $11.47 million/year 
  • Better patient care for community, be able to serve more people with same resources
  • If we implement program, for community PR show advocacy for Patient Safety, and increased patient satisfaction
  • Potential Revenue of an additional $11.47 million/year 
  • Be able to treat an additional 331 patients per year
  • eliminate unnecessary Length of Stay
  • cost of learners is 1 days of simulation and training
  • Be able to treat an additional 331 patients per year
  • Minimizing unnecessary length of stay of patients
  • Increased patient satisfaction
  • need to train medical students with evidence based best practices
  • need to have medical students training in an IPE environment to best prepare for current needs in Hospitals
  • have students prepared to operate in high risk, time pressured critical environments
  • better preparing the medical students given limitations on clinical hours
  • practicing in a simulated environment instead of on actual patients
  • need to train nursing students with evidence based best practices
  • need to have nursing students training in an IPE environment to best prepare for current needs in Hospitals
  • better preparing the nursing students given limitations access to clinical placements
  • practicing in a simulated environement instead of on actual patients
  • Better efficiency in the care of patients with the most common problems
  • increase the ability of staff to treat more patients
  • ability to retain staffing by showing value for patient satisfaction
  • ability to better adjust behavior as teams train together
  • making the case will involve a fully engaged staff of passionate educators
  • make clear that faculty educators must be trained to conduct deliberate practice and feedback
  • support a part of the institutions patient safey initiative to align with mission focus
  • focus on capturing the appropriate ROI metrics for you environment