BACKGROUND: Reducing delays for patients who are safe to be discharged is important for minimising complications, managing costs and improving quality. Barriers to discharge include placement, multispecialty coordination of care and ineffective communication. There are a few recent studies that describe barriers from the perspective of all members of the multidisciplinary team. STUDY OBJECTIVE: To identify the barriers to discharge for patients from our medicine service who had a discharge delay of over 24 hours. METHODOLOGY: We developed and implemented a biweekly survey that was reviewed with attending physicians on each of the five medicine services to identify patients with an unnecessary delay. Separately, we conducted interviews with staff members involved in the discharge process to identify common barriers they observed on the wards. RESULTS: Over the study period from 28 October to 22 November 2013, out of 259 total discharges, 87 patients had a delay of over 24 hours (33.6%) and experienced a total of 181 barriers. The top barriers from the survey included patient readiness, prolonged wait times for procedures or results, consult recommendations and facility placement. A total of 20 interviews were conducted, from which the top barriers included communication both between staff members and with the patient, timely notification of discharge and lack of discharge standardisation. CONCLUSIONS: There are a number of frequent barriers to discharge encountered in our hospital that may be avoidable with planning, effective communication methods, more timely preparation and tools to standardise the discharge process. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
BACKGROUND: Reducing delays for patients who are safe to be discharged is important for minimising complications, managing costs and improving quality. Barriers to discharge include placement, multispecialty coordination of care and ineffective communication. There are a few recent studies that describe barriers from the perspective of all members of the multidisciplinary team. STUDY OBJECTIVE: To identify the barriers to discharge for patients from our medicine service who had a discharge delay of over 24 hours. METHODOLOGY: We developed and implemented a biweekly survey that was reviewed with attending physicians on each of the five medicine services to identify patients with an unnecessary delay. Separately, we conducted interviews with staff members involved in the discharge process to identify common barriers they observed on the wards. RESULTS: Over the study period from 28 October to 22 November 2013, out of 259 total discharges, 87 patients had a delay of over 24 hours (33.6%) and experienced a total of 181 barriers. The top barriers from the survey included patient readiness, prolonged wait times for procedures or results, consult recommendations and facility placement. A total of 20 interviews were conducted, from which the top barriers included communication both between staff members and with the patient, timely notification of discharge and lack of discharge standardisation. CONCLUSIONS: There are a number of frequent barriers to discharge encountered in our hospital that may be avoidable with planning, effective communication methods, more timely preparation and tools to standardise the discharge process. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Entities:
Keywords:
HEALTH SERVICES ADMINISTRATION & MANAGEMENT; INTERNAL MEDICINE; discharge planning
Authors: Laura L Leets; Jennifer Cahill; Amber M Sprenger; Juli Simon Thomas; Rob Hartman; Mary E Poyner Reed; Haylee Manning; Marge Britt; Chrissy T Vu; Nicholas W Kohn; Sandi Aguirre; Sanith Wijesinghe; Sybil Klaus Journal: J Patient Exp Date: 2020-11-05
Authors: Kyan C Safavi; Taghi Khaniyev; Martin Copenhaver; Mark Seelen; Ana Cecilia Zenteno Langle; Jonathan Zanger; Bethany Daily; Retsef Levi; Peter Dunn Journal: JAMA Netw Open Date: 2019-12-02