Implementing a COVID-19 Discharge Pathway to Improve Patient Safety

Area of Science:

• Health Informatics
• Infectious Disease Management
• Patient Safety

Background:

• The period following hospital discharge presents significant vulnerability for patients diagnosed with coronavirus disease 2019 (COVID-19).
• Standardizing care for COVID-19 patients is crucial for improving outcomes and reducing readmissions.
• Existing discharge processes may not adequately address the complex needs of COVID-19 survivors.

Purpose of the Study:

• To implement and evaluate a novel COVID-19 discharge pathway within an electronic medical record system.
• To enhance patient safety by standardizing discharge processes for COVID-19 patients across a multi-hospital system.
• To integrate clinical guidelines and disposition requirements efficiently into the discharge workflow.

Main Methods:

• Development of a COVID-19 discharge pathway in the electronic medical record at UCHealth, a 12-hospital system.
• Key elements included consensus on discharge readiness, summarized criteria for disposition, and primary care follow-up protocols.
• Pathway utilization and patient outcomes (readmissions, 30-day ED visits) were tracked.

Main Results:

• The discharge pathway was utilized 821 times between April 20 and June 7, 2020.
• Among 436 patients discharged from the University of Colorado Hospital medicine service during the study period, 4% were readmitted and 3% had a 30-day emergency department visit.
• A notable trend observed was venous thromboembolism, highlighting a specific post-discharge concern.

Conclusions:

• The implemented COVID-19 discharge pathway effectively standardized care for a complex patient population.
• This electronic tool reduced cognitive burden on clinicians by integrating guidelines and disposition requirements in real-time.
• The pathway demonstrated a positive impact on patient safety, evidenced by low readmission and emergency department visit rates.