Standardized Discharge Planning Tool Leads to Earlier Discharges and Fewer Readmissions
Colleen Kucharczuk, Erin Lightheart, Allison Kodan, Cassandra Haynes, S. C. Rabatin, Joy Patricia Burke, Jamie Senger, Lindsay Lee, Sarah Brinley, Mary Angela Decena, Juanita M. Cruz, Rebecca Hirsh, Kathy McCauley
Abstract
BACKGROUND: In an inpatient setting, aspects of discharge planning are often left to the provider's memory, leading to errors, inefficiencies, and avoidable costs. METHODS: A multidisciplinary team of oncology practitioners used process improvement methodologies to redesign the discharge planning process. INTERVENTIONS: The primary intervention was an evidence-based discharge planning tool, called the discharge navigator, used from admission through discharge. RESULTS: Thirty-day unplanned readmission rates decreased by 29.0% from preimplementation (March 2017 through August 2017) to postimplementation (September 2017 through March 2020). The percentage of patients discharged before noon increased 76.2%. A comparable service not utilizing the intervention saw lesser or no improvement in these measures. CONCLUSION: The tool provided a systematic approach to discharge planning. Key design elements included a centralized location within the electronic health record and an electronic shortcut to populate the tool. Although developed for a specialized population, most elements are applicable to any hospitalized patient.