After a hospital stay, most patients are eager to return home or be discharged to another care facility. But, on the day of discharge there are often factors that can stall the process. For some time, the medicine team on 7 North at Brigham and Women’s Faulkner Hospital has been working to improve the discharge process so that many patients can leave the hospital before noon. Now, the providers on 6 North are doing the same with great success.
Many patients on 6 and 7 North are cared for by a multidisciplinary team of providers called the FACT medicine team. “After seeing the success the medicine team had on 7 North, the FACT medicine team decided to do the same on 6 North for consistency,” says Becky Mogensen, NP.
In February of 2018, the 6 North team began work to discharge as many patients as possible by noon. “Discharging patients before noon means the patient gets to leave the hospital sooner,” says Erin O’Fallon, MD. “It also means their bed is available for another patient who needs to be admitted. It truly is beneficial for everyone involved if we can get those patients who qualify discharged early in the day.”
To accomplish this goal, everyone is working together. “Physicians, nurse practitioners and physician assistants are working closely with the nursing team as well as case management and social work to have everything completed early in the day of discharge,” says Mogensen. “We meet as a multidisciplinary team in the morning to discuss all the patients in our care and identify those that can be an early discharge the following day. This way we can make sure all labs are completed, the patient has been seen by physical therapy or another consult service if necessary and hopefully they have a smooth transition to discharge.”
The goal is to discharge 20 percent of patients by noon each month. To keep everyone focused on the goal, a score board has been placed in the nurse’s lounge to encourage healthy competition among the staff. Already the initiative has proven to be very successful. In their first month, the team achieved 27 percent, well above the 20 percent goal.
“We know that there are some barriers to early discharge that we cannot control, such as care facilities not being able to accept the patient, changes in the patient’s condition, delays in transport, paperwork, etc.” says Dr. O’Fallon. “We are taking note of those factors that we can’t control and focusing our efforts on the factors we can control in the hopes of discharging as many patients as possible before noon each day.”
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