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Abstract
This paper is based on a comprehensive study of the discharge process at one of the busiest units of a 300-bed hospital. At this hospital, high patient turnover units, such as telemetry, regularly experienced admission bottlenecks due to a shortage of beds. Demand from the emergency department, surgical recovery room or the direct admits exceeded supply throughout the day. This study was conducted with two objectives in mind: (i) target reduction in the discharge time lag - the time from the physician signing the discharge orders to the time that the patient is escorted out of the room and (ii) reduce the total bed turnaround time - time from the patient escorted out to the time that the same bed is ready for the next admission. This study revealed that deploying a dedicated discharge nurse at the telemetry unit achieved a 32% improvement in the discharge time. The bed turnaround time, which includes the discharge duration along with the housekeeping wait time and bed cleaning time, also decreased by approximately 18%.
Keywords
Discharge Nurse, Discharge process, Bed turnaround time
1. Introduction
The rising healthcare costs have led hospitals to seek new ways to achieve operational efficiency while continuing to ensure patient safety and quality of care at the same time. Bed turnaround time has become a very important performance metric for hospital operations. In order to ensure a timely transfer of patients from the emergency room (ER) to the inpatient floors, it is necessary to have timely discharge of patients occupying the beds, thus ensuring short bed turnaround times. The discharge process is an important part of inpatient bed management and one of the crucial determinants of bed turnaround time.
This paper is based on the research findings from a detailed study of the discharge process at one of the busiest units (telemetry) at United Health Services (UHS), Wilson Memorial Regional Medical Center in Johnson City, NY. At this hospital, the two 26-bed telemetry units regularly experienced admission bottlenecks due to a shortage of beds. To gauge the extent of this problem, a study of the discharge process was initiated and performed during the period of December 2008 to March 2009. This study was conducted at the telemetry units based on past trends,...