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Take an Overview of Your Hospital’s Discharge Protocol

By Lisa Mulcahy via Multibriefs

You undoubtedly know how important it is for patients to be discharged promptly and safely at your hospital — but at so many facilities today, making that happen is a challenge. Time constraints, confusion during handoffs, and a lack of patient post-care awareness can make discharges unsuccessful and can lead to readmissions, or a worst-case scenario, patient mortality.

Use a focused approach to evaluate how well your discharge system is working, and make necessary changes using this research-based information.

Require a complete exam before a patient is discharged.

A study from UT Southwestern found that a surprising 20 percent of patients are discharged from hospitals with unstable vital signs, like elevated heart rate or low blood pressure. This can lead, obviously, to readmissions and even the potential of patient death.

Clear every patient completely before starting any paperwork — and make sure your residents, nurses and other physicians know it's much more important to keep such a patient than to clear a bed.

Involve the patient's family and friends.

Research from Women and Infants Hospital found that patients who were walked through post-discharge plans with a caregiver present did well at sticking to those plans once they were home. Encourage your patients to choose a friend or family member in this way.

Monitor beds on an ongoing basis.

British researchers studied a hospital and reported that each additional day a recovered patient was kept waiting for a discharge due to red tape, an average of approximately seven acutely ill patients died in the same facility.

The researchers think this is because beds for the most critical patients were not available soon enough. As previously stated, the last thing you want to do is discharge an unstable patient in order to clear a bed.

At the same time, it's crucial to monitor for admission logjams. Reassigning residents to handle both discharge and admission overflow at busy times is a solution to employ.

Review your paperwork protocol.

Take a good, hard look at where discharge delays stem from by tracing the paper trail at your hospital. Where can things be streamlined? Ask your doctors and nurses for their input as to how to make the process simpler.

Talk to your patients.

There's nothing worse than sitting in your room for hours waiting to go home. Visit each floor and ask patients waiting to be discharged what their experience is like. Is the wait too frustrating?

What can you provide them to make it easier — a meal, for example? Getting as much information from your patients directly will allow you to make any wait more pleasant for them, and they'll appreciate the fact that you care.

Lisa Mulcahy is an internationally established health writer whose credits include the Los Angeles Times, Redbook, Glamour, Elle, Cosmopolitan, Health, Good Housekeeping, Parade, Woman's Day, Family Circle and Seventeen. She is the author of eight best-selling books, including "The Essentials of Theater," an Amazon No. 1 new release.


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