Patients in Sunrise Health Region determined to no longer require acute care were remaining in acute care beds an additional 18.5 days, on average. This was due in part to a delay in alternate care arrangements and lack of knowledge regarding available respite and transition beds. These other locations are more appropriate for these patients because they will receive the care they need in a setting that is more suitable to their care needs.
Through a rapid process improvement workshop (RPIW) a team of front-line staff and client representatives clarified and simplified the processes for discussing and determining discharge needs. As well, they improved the ability of front line staff to access the more appropriate care options by making bed availabilities visible to staff in “real time” through the implementation of a “Summary Spreadsheet” on the staff website.
Staff can now “see” the availability of respite beds throughout the region because of this accessible information. As well, the multidisciplinary care team now has clear guidelines to ensure that discharge options are identified when patients no longer require acute care services. Rhonda Hawkins, medical social worker and a member of the discharge planning team, emphasized,
“Discharge planning rounds seem to be more efficient [with the new process] which frees up time for the team members to deliver patient care.”
Rhonda Hawkins, medical social worker and a member of discharge planning team
Knowing their discharge date sooner and having care in the most appropriate and comfortable setting is better for the patient. Bonnie Cobb, who was a client representative in the RPIW, provided the perspective of the patient during the planning process.
“Being informed of a potential discharge date will help families communicate with each other and help families in moving forward with plans related to the discharge date.”
Not only is the patient discharged to a more appropriate location in a timelier manner, doing so, frees up acute care beds for acutely ill patients. Following the RPIW, the average days spent in an acute bed, after it has been determined that the patient no longer requires acute care, dropped to 9.4 days.
“It is great to have staff and patients on the RPIW team improving the quality of our services,” says Perry Froehlich, Director of Kaizen Promotion and Patient Safety. “Our lean training has demonstrated that when we focus on our goal of improving quality and safety, a reduction in costs often follows as an indirect result that is also beneficial. There is still room for improvement in our discharge processes and I expect we will revisit discharge planning in the future to make further improvements to reduce unnecessary waits for patients in hospital.”