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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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Presentation Transcript
slide2
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 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
slide10
9.1 Hrs

8.4 Hrs

7.6 Hrs

6.3 Hrs

6.3 Hrs

5.0 Hrs

4.5 Hrs

January 2010 Data

slide11
53%

47%

1st 5 Hours

Hours 6 - 33

January 2010 Data

slide12
Noon

January 2010 Data

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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