A Multidisciplinary Initiative to Increase Inpatient Discharges Before Noon

J Nurs Adm. 2016 Dec;46(12):630-635. doi: 10.1097/NNA.0000000000000418.

Abstract

Objective: The aim of this study is to evaluate the effect of 2 hospital-wide interventions on achieving a discharge-before-noon rate of 40%.

Background: A multidisciplinary team led by administrative and physician leadership developed a plan to diminish capacity constraints by minimizing late afternoon hospital discharges using 2 patient flow management techniques.

Methods: The study was a preintervention/postintervention retrospective analysis observing all inpatients discharged across 19 inpatient units in a 484-bed, academic teaching hospital measuring calendar month discharge-before-noon percentage, patient satisfaction, and readmission rates. Patient satisfaction and readmission rates were used as baseline metrics.

Results: The discharge-before-noon percentage increased from 14% in the 11-month preintervention period to an average of 24% over the 11-month postintervention period, whereas patient satisfaction scores and readmission rates remained stable.

Conclusions: Implementation of the 2 interventions successfully increased the percentage of discharges before noon yet did not achieve the goal of 40%. Patient satisfaction and readmission rates were not negatively impacted by the program.

MeSH terms

  • Capacity Building / methods
  • Capacity Building / organization & administration
  • Capacity Building / standards*
  • Efficiency, Organizational
  • Hospitals, Teaching / organization & administration
  • Hospitals, Teaching / standards
  • Humans
  • Institutional Management Teams / organization & administration*
  • Institutional Management Teams / standards
  • Interdisciplinary Communication
  • Organizational Case Studies
  • Patient Discharge / standards*
  • Patient Discharge / statistics & numerical data
  • Patient Readmission / statistics & numerical data
  • Patient Satisfaction / statistics & numerical data
  • Time Factors
  • Total Quality Management / methods
  • Total Quality Management / organization & administration
  • Total Quality Management / standards