Quality Improvement: Undergraduate contribution to identify barriers to patient discharge timeliness

Abstract

The undergraduate quality improvement project goal was to determine the primary barriers to timely discharges through a clinical leadership practicum experience at an advanced tertiary care teaching hospital.  Delays in discharges are associated in the literature with adverse health outcomes and diminished efficiency within organizations. The authors retrieved deidentified data in real-time from the health information system and interactions with patient care staff. The study’s metrics included 1) discharge orders placed before 10 a.m, and 2) patients discharged before noon. The primary barriers found were ambulance transport delays and scheduled treatments after target discharge times. Early identification of patients planned to discharge aided in readiness and increased numbers of patients discharged before noon. The information collected by undergraduate students will help address the primary barriers and assist further quality improvement initiatives within the affinity group.