Discharging patients from the hospital can be like getting ready for a big game, everyone involved needs to understand their role.
An oversight, misstep, or lapse in communication can lead to a longer length of stay, unnecessary costs and one fewer bed for an incoming patient. Harber discusses how intelligent automation, the use of artificial intelligence, workflow automation, and communication to detect and mitigate risk and create action in real time, can improve discharge processes and take the burden off overtaxed staff members.
What do you see as one of the top hurdles hospital face in managing timely patient discharges?
Breakdowns in communication can be a huge barrier to timely discharges.
“A successful discharge requires that case management, nursing, hospitalists, outside physicians, and ancillary departments are all working toward the same end goal for each patient,” says Harber. This reinforces the need for efficient, ongoing communication within an environment that struggles to supports it. “Management teams are often separate and physically siloed, so collaboration is very difficult,” says Harber.
Some organizations will try to bridge this communication gap by performing huddles or multi-disciplinary rounds. “Although these events often occur daily, they rarely result in targeted actions to ensure a successful day, leaving care teams siloed,” says Harber. However, using technology to engage care teams in their daily work offers the opportunity to replace manual methods, enabling teams to align on priorities and coordinate discharge activities throughout the day, ensuring everyone aware of patient progress, and any potential roadblocks.
Are there any system-wide discharge practice improvements that hospitals should be adopting?
“The first thing I would say is to understand who the operational leader is,” says Harber. “When you ask who is ultimately responsible for ensuring that patients are discharged each day, very often those involved point the finger the other way.”
To solve this problem, some organizations have designated a point person to oversee the process. “The position is typically the director of patient throughput,” he says. A number of facilities have devoted resources to the position, which has the sole responsibility of coordinating discharges and ensuring patient throughput. In some instances, organizations have designed the position as a virtual nursing function, so the unit is separate, but always digitally overseeing discharge-related activities.
The second part is ensuring consistency in the discharge process across the health system. Properly managing capacity across the enterprise can help the organization achieve new levels of performance excellence, profitability, and patient care.
What are the benefits of using intelligent automation to optimize discharge practices?
Intelligent automation encourages communication between team members and can reduce length of stay and streamline processes to free up overloaded staff members. Supporting discharge processes with a robust technology platform can provide a pressure-relief valve. “If we can move the patients in the system more efficiently and find ways to collaborate safely and effectively to move them to the next level of care, it’s not only better for the patients, but it’s also good for your staff,” he says.
These advanced technology platforms can also help organizations reduce length of stay by anticipating and prioritizing discharges, and clear census-related bottlenecks that can occur when nursing units don’t know when new patients will arrive. Having a system that can alert staff members when patient demand is set to increase and automatically identifies patients who were supposed to go home yesterday, but didn’t, allows them to plan more effectively.
Missed discharges often occur because a patient was missing a needed medical test or a because post-acute transition wasn’t ready. “We use predictive analytics to identify missing tests, or to determine whether a patient will have a post-acute need as early as possible,” he says. Spotting potential barriers to discharge promptly allows them to be cleared before they impede the process.
What are some improvements and results you've seen with hospitals incorporating intelligent automation into their discharge practices?
“Clients using our platform are able to shave a half day off the average length of stay,” says Harber. Intelligent automation solutions also save time, and paper. Staff members can use a tablet, instead of a clip board, carrying it with them to work at the bedside. It also expedites work on the back end. “You could be talking about hundreds of hours of labor that would have been spent collating data and reviewing data that can now be directed toward patient care,” says Harber.
Advanced technology platforms can unify team members to work toward a common goal. “We embed messaging and social components into the platform,” says Harber. Users can send notes and tag others, to ensure alignment. “It’s a great way to get everybody focused on the same thing,” he says. Ultimately, intelligent automation helps discharge safely and efficiently. “If the system is faster, we can take care of more patients,” says Harber.
Executive Vice President, Operations