Discharge to door
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Discharge to Door. Kaizen #3. Team. Nurse Practitioner: Nurse: Pharmacist: Hospitalist: Radiology: Care Manager: Social Worker: Home Health: Accounting: PI Coach: Patient: Palliative Care:. Event Expectations. Document Current State Discharge Process

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Discharge to Door

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Discharge to door

Discharge to Door

Kaizen #3


Discharge to door

Team

  • Nurse Practitioner:

  • Nurse:

  • Pharmacist:

  • Hospitalist:

  • Radiology:

  • Care Manager:

  • Social Worker:

  • Home Health:

  • Accounting:

  • PI Coach:

  • Patient:

  • Palliative Care:


Event expectations

Event Expectations

  • Document Current State Discharge Process

  • Develop a Future State Discharge Process

  • Capture “Before” Event Metrics

  • Create Discharge Audit Form & Team

  • Develop Action Item List

  • Develop Final Presentation


Current state flow chart

Current State Flow Chart


Current state flow chart1

Current State Flow Chart

Discharge

Order

Written

Nurse Secretary discovers discharge order in chart

First time anyone knows discharge is eminent


Major blocks

Major Blocks

Clinical

Housing, Meds, Transportation

1st 4 Hours

Next 4 + Hours


Current state flow chart2

Current State Flow Chart

Discharge

Order

Social Worker

Nurse

Secret-

ary

Charge

Nurse

Care Manager & Pharmacy

Care

Partner

Bedside Nurse


Current state flow chart3

Current State Flow Chart

Discharge

Order

Social Worker

Nurse

Secret-

ary

Charge

Nurse

Care Manager & Pharmacy

Care

Partner

Bedside Nurse


Data analysis

Data Analysis

  • 59 Patients chosen at random from thousands

  • January patients chosen since their records would be complete

  • Measuring time from Doctor’s (discharge) order to time patient was checked out of system


Discharge to door

9.1 Hrs

8.4 Hrs

7.6 Hrs

6.3 Hrs

6.3 Hrs

5.0 Hrs

4.5 Hrs

January 2010 Data


Discharge to door

53%

47%

1st 5 Hours

Hours 6 - 33

January 2010 Data


Discharge to door

Noon

January 2010 Data


30 day action items

30 Day Action Items


30 day action items 2

30 Day Action Items (2)


Future state

Future State

“Pending Discharge”

Order (24 Hrs in

Advance)

Social

Worker

Care Manager

Care

Partner

Clinical

Dis-

charge

Nurse

Secret-

ary

Charge

Nurse

Pharmacy

Bedside Nurse


Event outputs

Event Outputs

  • Document Current State Discharge Process

  • Develop a Future State Discharge Process

  • Capture “Before” Event Metrics

  • Create Discharge Audit Form & Team

  • Develop Action Item List

  • Develop Final Presentation

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