Hospital Discharge Process Improvement Strategies

Introduction

The hospital discharge process is a critical administrative task that requires critical reform. Hospitals are faced with various logistical challenges that occur due to an inefficient discharge mechanism. This results in an increased length of stay, scheduling issues, and high rates of readmission, which accrue costs and limit patient satisfaction. The overcrowding of medical facilities has been primarily due to constricted patient flow as processes such as discharge become more complex and unorganized (El-Eid, Kaddoum, Tamim, & Hitti, 2015). There is an evident lack of standard or efficiency. The hospital discharge process can be improved by simplifying and delegating necessary duties to members of the medical team as well as focusing on the patient education factor to limit readmission.

Workflow Chart

The first part of the flowchart focuses on preparation for discharge. It is a multistep process of examining the patient, communicating the intention to discharge, and ensuring the treatment is complete. The physician does it with the help of the nursing staff. Technology that is used in this step is primarily electronic health records for keeping track of the patient’s treatment. Usually, states have laws in place on patient discharge, indicating that a medical evaluation must occur to determine the conclusion of treatment and the patient consulted about the process. The information needed to complete this test is primarily the result of all completed treatments and analyses. This step was included due to the prevalence of patients discharged with pending diagnostic test results.

These are necessary for ensuring the individual’s appropriate treatment as well as a safe transition of care, which includes a comprehensive follow-up plan. At least 70% of patients are discharged with pending results, and only 18% of these were adequately noted in the discharge summary. It is estimated that a significant portion of physicians is unaware of the returning results, despite 9% requiring further intervention (Kanton, Evans, & Shieh, 2015). The health of the patients is endangered in such cases, and there is a high risk of readmission. Including these steps in the initial stages of hospital discharge protocol is necessary to ensure liability.

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The next step is to evaluate the patient condition to determine physical and mental capability. At this point, the multidisciplinary approach is considered to determine the need for transfer to another facility for further treatment or residential care. Usually, the nursing staff aids with the paperwork, and a case manager investigates the patient’s plan of care after discharge. Electronic health records are once again instrumental in noting and tracking the necessary information. Legal frameworks on discharge exist in each state to guide this process ensuring it is safe to release the patient and there is an availability of proper aftercare. Information for completing this step is based on medical history and assessment. This information is used to determine whether there is a need for a simple or complex discharge. A simple discharge can be accomplished at the ward. Meanwhile, elaborate discharges that include transfers, social care, or additional accommodations are more intricate (Lees, 2013).

The last step consists of a comprehensive approach to finalizing the plan of care for the patient. That includes filling out prescriptions, patient education, and filling out paperwork. The physician, nursing staff, and administrative personnel are involved. In a simple discharge, the process is straightforward. However, in a complex discharge, a social worker may need to get involved to determine the next steps of care for the patient. It may be necessary to transfer the patient to another facility or contact social services to provide individual life-sustaining assistance at home. Electronic health records are used to record the information and send it to other facilities if necessary. Each hospital system maintains its policies on the procedures and rules to finalizing the discharge. Paperwork is completed with all contact or insurance information on the patient. Additional information may be required on a case-by-case basis. During this process, it is critical to emphasize the plan of care including education, follow-up appointments, and instructions for the patient that are easily understood (Horwitz et al., 2014). This improves the overall quality of the discharge practice that helps lower readmissions.

Evaluation and Improvements

Hospital discharge is evaluated by several parameters. There are statistical indicators that are based