Delays in Discharge in Neuro-Oncology: Using a Lean Six Sigma-Inspired Approach to Identify Internal Causes

Discharge planning processes have implications for patients and families, healthcare providers, and organizations at large. As such, delays in discharge may result in suboptimal patient outcomes, increased resource utilization, and overall disruptions to patient flow. A quality improvement project was conducted using a Lean Six Sigma approach to identify internal causes of delays in discharge in newly diagnosed patients with a high grade glioma on a neurosurgical unit. Internal causes of delays in discharge were related to communication. The main subthemes were multidisciplinary rounds, incongruent messages being delivered to patients and families, and discrepancies between team members resulting in unclear plans. Findings from this project may be used to promote more effective communication that will facilitate safe and timely discharge for neuro-oncology patients.