Effectively managing the discharge process is universally recognized for its impact on efficient patient flow and its bearing on unnecessary bottlenecks.
Although concept sounds simple: deliver efficient care, minimize delays, and discharge patients earlier than you do today; without the right processes and systems in place, it’s anything but that.
After nearly two decades working in hospital operations, capacity management and patient flow, I’ve had the opportunity to meet with hundreds of hospital leaders, observe the real-world experience and workflow of front-line teams, and understand the volume of data and decisions cross-functional teams require to effectively manage the discharge process. These top 5 recommendations are the culmination of that expertise, representing proven strategies to enable an effective discharge process, and ensure performance improvement gains remain constant and sustainable:
- Assign a Day-to-Day Operational Leader
This is a designated individual who owns the initiative and is responsible for daily throughput needs and the coordination of care by front-line teams. This cannot be a largely ceremonial title. This individual must have real authority or influence; be empowered to gather solid, reliable data from all areas; break down barriers; and be provided the tools necessary to design, test and implement improvements.
- Develop a Coordinated System-Wide Process
The organization as a whole must view the patient discharge process as a connected approach. Each patient’s care progression, as well as the impact to the enterprise as a whole, must be understood. Steps in the process cannot be managed in a silo and escalation protocols must be clear. This creates a system-wide process that is coordinated, proactive, and constantly adapting.
- Implement a System for Accurate Predictive Insights
Capacity crises and avoidably delays are largely preventable if care teams have the right data to take action in advance. Understanding anticipated census, identifying the day’s most impactful discharges, prioritizing units reaching or over capacity, and escalating situations that require hospital-level coordination puts everyone on the same page with what needs to be done to ensure 1) patient length of stay is not unnecessarily extended, and 2) beds are available for anticipated incoming patients.
- Identify Discharge Barriers and Provide Recommended Actions to Remove Them
The organization must identify potential discharge barriers and deliver specific action plans (at the system and at the unit level) to resolve them (e.g., classification, outstanding tests, post-acute needs and placement). This requires a synchronized approach across multi-functional teams so everyone knows what they need to do, has a timeline for when it needs to be done and understands the impact on other units and the enterprise as a whole.
- Eliminate Communication Silos
Once everyone knows what they need to do to ensure success, there must be an effective method to communicate progress and updates, and request support if needed. Manual communication methods like phone calls, written notes, text messages, emails, etc. are untimely, inconsistent and often siloed, causing items to be missed or work to be duplicated. All cross-functional areas must work from a “’single source of truth” to identify, understand, address and communicate status on critical priorities. And for front-line teams, everything must accessible in real-time from where they are, whether rounding with patients, in a huddle, or in a logistics center.
Achieving these best practices requires an enterprise commitment to discharge performance excellence along with having right systems in place to ensure success. Today, AI-based operations management systems are being used in hospitals and health systems of all sizes to deliver meaningful digital transformation to effectively enable each of these recommendations. The most effective platforms use intelligent automation to integrate data elements across systems; embed the data science of artificial intelligence (AI) predictive analytics, simulation, and optimization; and provide a digital, closed-loop communication platform for multidisciplinary team members.
By imbedding intelligent automation within current operating procedures; AI-based systems deliver predictive insights, recommend the most meaningful actions and streamline how work is done. Organizations that have adopted intelligent automation have achieved systemic and sustainable improvements in all operational areas including patient flow, capacity management, perioperative utilization and nurse staffing. For discharge practice improvement specifically, the benefits are clearly identified in decreased discharge delays, shortened lengths of stay, reduced emergency department boarding and more - for the benefit of the entire health system as well as each patient.
Jason Harber is the vice president of operations at Hospital IQ. To learn more about how Hospital IQ’s Inpatient Solution is being used to optimize discharge practices, download the whitepaper: Optimizing Hospital Discharge Practices through Intelligent Automation