Weekly Comprehensive Assessments for Optimizing Care of Patients With a Discharge Delay

The purpose of this project was to explore patient safety, quality outcomes, and staff satisfaction related to decreasing comprehensive patient assessments to once weekly for patients with a discharge delay.

The project involved piloting once-weekly comprehensive assessments for medically stable patients on a general medical-surgical unit and a long-stay unit. The pilots aimed to reduce the frequency of comprehensive assessments while maintaining patient safety, reducing patient interruptions, and improving staff satisfaction.

The pilot for the general medical-surgical unit had low compliance and was discontinued. However, the pilot in the long-stay unit was successful, saving nurses an estimated 3534 minutes per week. Several measured quality indicators improved, although there were small increases in hospital-acquired pressure injuries and Clostridioides difficile infections. Staff satisfaction was high, with 87.5% of nurses supporting the continuation of weekly assessments.

The project demonstrated that weekly comprehensive assessments are effective for patients with delayed discharge who are medically stable. This intervention has the potential to be implemented in other units and organizations as long as appropriate patient identifiers are in place.