Background: Discharge delays occur because of inconsistent communication among all clinicians and providers. Inefficient utilization of resources also contributes to delays. Effective communication among the patient care team is a foundation of creating an effective discharge planning process. We must standardize the process of communication as well as resource optimization in order to provide our patients safe and timely discharge. We created a platform through the comment section in the electronic medical record (EMR) system for multidisciplinary communication where all involved disciplines can contribute and receive updates on discharge planning. This required a change in practice for care coordination, nursing staff, therapy, nutrition, medical providers, and other members of the multidisciplinary team. Successful implementation and utilization of the discharge planning tool involved education of staff, therapy, care coordination and physician care teams.
Purpose: The aim of the project is to create a platform in which multiple disciplines can communicate in the EMR system regarding discharge planning for patients. The goal is to improve communication and decrease avoidable hospital days.
Description: This project was developed as a result of a process improvement event, using the principles of lean methodology, with the goal of improving the discharge process. A gap analysis was performed of the current state of the discharge process. The following reasons for delay in discharge process were identified: the timeliness of the placement of the discharge order by the physician team; delay in discharge due to medications; lack of multidisciplinary communication; inconsistent resources on the day of discharge; lack of transportation to home as well as patient readiness were identified. In addition inappropriate or untimely physical therapy and occupational therapy consult orders were also noted. A platform was created through the comment sticky note section in the EMR for multidisciplinary communication whereby all involved disciplines can contribute and receive updates on discharge planning. The initial state, goal state and progress over a 4 month period since implementation of the tool is shown in Table 1. An example of the multidisciplinary discharge planning tool is shown in Table 2.
Conclusions: Hospital throughput relies heavily on efficient multidisciplinary team communication. The use of a discharge planning communication tool embedded in the EMR is accessible to the patient’s team improves communication on discharge and contributes to a reduction in avoidable hospital days.
