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Published on: September 30, 2020
Standardized Discharge Planning Tool Leads to Earlier Discharges and Fewer Readmissions
Colleen Kucharczuk1, Erin Lightheart, Allison Kodan
1Departments of Advanced Practice (Dr Kucharczuk and Mss Kodan, Haynes, Rabatin, Senger, Lee, and Decena), Quality and Safety (Ms Lightheart), Inpatient Pharmacy (Dr Brinley), Clinical Resource Management (Ms Cruz), and Medicine (Dr Hirsh), Hospital of University of Pennsylvania, Philadelphia; Division of Hospital Medicine, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania (Ms Burke); and University of Pennsylvania School of Nursing, Philadelphia (Dr McCauley).
Background:
In an inpatient setting, aspects of discharge planning are often left to the provider's memory, leading to errors, inefficiencies, and avoidable costs.
Methods:
A multidisciplinary team of oncology practitioners used process improvement methodologies to redesign the discharge planning process.
Interventions:
The primary intervention was an evidence-based discharge planning tool, called the discharge navigator, used from admission through discharge.
Results:
Thirty-day unplanned readmission rates decreased by 29.0% from preimplementation (March 2017 through August 2017) to postimplementation (September 2017 through March 2020). The percentage of patients discharged before noon increased 76.2%. A comparable service not utilizing the intervention saw lesser or no improvement in these measures.
Conclusion:
The tool provided a systematic approach to discharge planning. Key design elements included a centralized location within the electronic health record and an electronic shortcut to populate the tool. Although developed for a specialized population, most elements are applicable to any hospitalized patient.
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