In many situations, the most successful approach is to begin with the end in mind. That is especially appropriate when it comes to capacity management. Effective admissions and patient throughput rely on proactive discharge planning. A hospital discharge process that begins as soon as the patient is admitted can reduce the length of stay, eliminate unnecessary excess days, increase overall capacity, and improve access to care.

After spending years in hospital operations addressing patient flow and throughput issues, it’s exciting to work with our Hospital IQ customers to help them deploy intelligent automation that improves their workflows. We’ve seen powerful results when we focus on improving hospital discharge processes.  Here’s a snapshot of the issues many hospitals face and how we collaborate with customers to apply process improvements and achieve proactive discharge planning.

 

The hospital discharge process domino effect

Late or missed discharges have a negative downstream impact that results in avoidable excess days, increased length of stay, and throughput bottlenecks. Ultimately, discharge process issues can limit access to care by decreasing overall capacity. 

The majority of hospital discharge delays are caused by tasks and tests missed on day 1 and 2 of a patient’s stay, creating barriers and bottlenecks later in the patient care journey. Another barrier to discharge can be a limited awareness of the post-discharge plan early in the patient stay. Without knowing where the patient will be discharged to, discharge planning is delayed or incomplete.

 

Understanding the gaps between the vision and the reality

Processes that are fully dependent on people, with a lack of true automation to recommend, escalate, and drive action for sustainability can prevent the vision from becoming reality. When staff do not have situational awareness about projected discharge dates and the tasks, tests, and procedures that must be completed to meet the target, it can be nearly impossible to discharge 50% of patients by early afternoon. In fact, target discharge dates are often missed completely.

Without automation, the team will struggle with these challenges: 

  • A lack of early awareness of key components of the discharge plan:
    • Where is the patient going?
    • Which tasks, tests, and barriers need to be addressed and when do they need to be completed?
    • Who is responsible for those outstanding tasks, tests, and barriers?
  • Inability to force rank/prioritize the order of patients to discharge first, second, third, etc.

 

Envisioning a better hospital discharge process

Our clients’ hospital discharge processes have benefitted from discharge sequencing and prioritization. By projecting probable discharge dates and then prioritizing tasks and tests according to a sequence that aligns with those target discharge dates, our client can often:

  • Complete 25% of daily discharges by 11 am
  • Complete an additional 25% of discharges by 2 pm

That reduces avoidable excess days and overall length of stay. 

 

Use technology to help bridge the gap

Intelligent automation should be designed to give caregivers and leaders time back to spend on value-added work. When technology eliminates the unnecessary time spent hunting down relevant information, caregivers spend less time in meetings, huddles, or clicking through technology trying to figure out the items identified as gaps. The result – more time focused on care delivery and a better hospital discharge process.

Here’s the functionality to look for when you’re seeking technology-enabled solutions for proactive discharge planning: 

  • Accurate census forecasts by unit and level of care so staff know what’s coming and can focus on aligning of staff, resources, and capacity management to meet discharge targets.
  • Automatic detection of bottlenecks and barriers, then communicating alerts to drive action so that they can be avoided or removed before they delay discharge. 
  • Forecasting GMLOS and discharge plans, including disposition, upon admission of every patient to allow for early multidisciplinary team alignment and planning.
  • Projecting and recommending tests, tasks, and barriers commonly completed prior to discharge. Gain data trust by showing criteria used to drive the forecast, along with a confidence factor or percentage of times these things occur in these patient types.
  • Continuously surveilling all system data, applying defined workflow rules to automatically notify appropriate individual staff or care teams when to take action to prevent issues. Defining what action to take, who should take the action, and auto-escalating to leaders when actions are not resolved within a time frame. 
  • Auto-communicating an “all clear” to appropriate team members after action is taken and problem is resolved.

Pursuing discharge excellence

Proactive hospital discharge processes are an important part of an effective overall patient flow and capacity initiative. AI-based operations management platforms that use intelligent automation can help health systems significantly elevate discharge performance across the entire enterprise.

For an in-depth look at how to improve discharge processes, check out our ultimate guide, Optimizing Hospital Discharge Practices with Intelligent Automation.

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