Shortening the Discharge Process on the General Pediatric Floors: A Quality Improvement Initiative

      According to Journal of Hospital Medicine, 22.8% of all patients experienced at least one delay in their care, accounting for 82 delay-related hospital days and $170,000 in cost. 42.3% of those delays were resulted from physician behavior, and approximately 25% of patients could have discharged sooner than they were. The general pediatric floor at Jersey Shore University Medical Center is a 28 bed unit, managed by one general pediatric attending, two senior pediatric residents, and two pediatric interns during the day, and one pediatric senior resident and one intern at night. The discharge tasks fell on the daytime interns, who also had several other clinical responsibilities. As a result, prior to implementation of our quality improvement project in 2013, the average time for a patient to be discharged after rounds was 218 minutes. This time was inclusive of determination of the discharge plan, preparation of home prescriptions, coordinating home health and other home nursing issues, and contacting subspecialists for follow-up appointments.
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