Abstract
Communication about the discharge process is often lacking. Families and nurses are often unaware when a discharge is expected or what goals need to be met prior to discharge. We aimed to improve the discharge process in hopes of improving patient and staff satisfaction and patient throughput. Through our established quality group, we identified areas to focus on for improvement of the discharge process. From these, we selected discharge goals and an anticipated date of discharge as two areas to intervene. We began by surveying families and nurses as to their understanding of what goals a child needs to meet prior to discharge and when discharge was anticipated. The survey found many families and nurses did not know this basic information. In order to improve these, we decided to place wipe boards in all the patient rooms to be completed during daily rounds documenting discharge goals and an anticipated day of discharge. Nurses and families were challenged to be present during rounds and encouraged to contribute and ask questions and the staff was educated. We then began performing several tests to refine the process and evaluate its impact. A schedule was made where one service per week would begin using the boards with adjustments made as needed. At baseline, 67% of families and 19% of nurses knew the goals a patient needed to reach prior to discharge. With use of the wipe boards for the families, this initially remained at 67% on our first trial and improved to 72% during the second. For the nurses it improved to 33% with our first trial and 64% with the second. At baseline, 56% of families and 11% of nurses knew an anticipated time of discharge. After initiation of the wipe boards for the families, this improved to 67% after the first trial and 75% during the second. For the nurses it improved to 33% during the first trial and 62% during the second. The use of the wipe boards placed in the patients’ rooms resulted in an increased percentage of nurses and families who were aware of discharge goals and an anticipated date of discharge. Our hope is that as we expand this to other services, we will see continued improvement in the discharge process. We then plan to address other areas of the discharge process including care management, patient education, and paperwork at discharge. This should result in increased satisfaction and better throughput.
