Standardization of the Discharge Process for Inpatient Hematology and Oncology Using Plan-Do-Study-Act Methodology...

Area of Science:

• Healthcare Quality Improvement
• Oncology Patient Management
• Hematology Patient Care

Background:

• Hematology and oncology patients require timely follow-up to prevent complications and treatment delays.
• Follow-up within 14 days is linked to reduced 30-day readmissions, especially for high-risk individuals.
• Current discharge processes may lead to delays in essential post-treatment care.

Purpose of the Study:

• To implement a standardized discharge process for hematology and oncology services.
• Primary goal: reduce average time to follow-up appointments to less than 14 days.
• Secondary goal: improve communication and decrease process variation.

Main Methods:

• Utilized Plan-Do-Study-Act (PDSA) methodology for quality improvement.
• Developed a standardized discharge process with a multidisciplinary team.
• Implemented physician training, a discharge checklist, and a clinical decision support tool.

Main Results:

• Average time to follow-up decreased from 17 days to 10 days by PDSA cycle 3, achieving the <14-day target.
• Process variation significantly reduced, with the upper control limit dropping from 58 to 21 days.
• Electronic alerting of outpatient providers to discharge summaries increased from 20% to 62% (P = .01).

Conclusions:

• Standardizing the discharge process effectively decreased time to follow-up appointments in hematology and oncology.
• Improved communication between inpatient and outpatient teams was observed.
• Timelier follow-up is crucial for preventing clinical decompensation and treatment delays in this patient population.