ABSTRACT

A Capacity Management Oversight group was formed at an Academic Medical Center to explore options to alleviate the overcapacity situations that have historically hampered patient flow and operational efficiencies. 42% of discharge patients leave the facility after 4pm while beds are needed for new patients prior to 4pm. Much of the delay is attributed to patients awaiting transportation home. Recent HCAHPS scores indicated areas for opportunity to improve the patient experience related to discharge preparation A feasibility study was completed recommending a Discharge Lounge (DCL) for hospital patients awaiting transportation home. The goals of the DCL were to promote patient flow through earlier hospital discharge while improving patient experience regarding discharge preparation. The DCL would be available to patients being discharged to Home with Self-Care. During their wait time DCL staff, Registered Nurses (RNs) and Licensed Nursing Assistants (LNAs), would engage with the patient to review key discharge information such as medication compliance and knowledge, follow up care recommendations, and self-management at home. In the first year of operation the DCL serviced 62% of patients discharged to Home with Self-Care. Patient experience scores in the first year of operations showed 3% increase in the area of discharge information; 1.9% increase in information about medication side effects; 1.9% increase instructions for care at home; 5% increase staff talked about help when you left; 3.6% increase in satisfaction with instructions for care at home. This approach to managing patient flow in a capacity constrained environment from the patient’s perspective is an exceptional opportunity to address operational barriers to patient flow from the lens of the patient.