Student Dissertation

Agency : Discharge Process, Turnaround Time, Bed Locking

Objective : Objective of the study was to find out the turnaround time of discharge process of Asian Heart Institute and Research Institute and to do a Gap analysis of the process being followed and the standard operating procedures.

Background : Discharge process being the final step in the hospital experience is likely to be well remembered by the patient. Even if everything else went satisfactorily, a slow, frustrating discharge process can result in low patient satisfaction

Methodology : This was a cross sectional study done for a study period of 45 days where type of analysis done was quantitative and qualitative. A Non-Probability purposive sampling was done. Direct Observation, Interaction with nursing, billing and pharmacy staff. Participation in almost all discharge Process for getting accurate data was done for primary data collection while secondary data was collected from time extracted from HIS. Data extracted from patient File.

Findings : The data collected was analyzed to find all factors responsible for delay in discharge process. All the factors were broadly divided into hospital side delay, patient side delay, TPA delay, delay due to medical reason which were unavoidable and delay due to gap in information flow. Out of all the factors, hospital side delay and delay due to gap in information flow were found to the main reasons leading to delay.

Recommendations : In order to reduce the delay in the discharge process it was important to first distinguish the factors that were in control of the hospital so that changes in the process can streamline the discharges thus leading to prevent delays. Focusing on such factors & their entire process flow will help in reducing wastage and optimize utilization of resources with an added return in the profits. This will also enhance the quality of services delivered and thereby affect the patient satisfaction. Definition of Discharge - “It is to formally terminate a patient’s care and releasing him/her from the hospital or health care facility. A patient is discharged only when he/ she have recovered fully or satisfactorily according to concerned physician”. It is imperative to have a timely discharge. A delayed discharge has an adverse impact on the physical, mental, emotional and psychological stems of the patient and also has negative financial implication on the hospital. A patient staying longer than the stipulated time is responsible for unnecessary utilization of the hospital resource and is sheer waste. Delayed Discharge (sometimes referred to as delayed transfer or Bed Locking), refer to the situation where a patient is deemed to be medically well enough for discharge, but, where the patient is unable to leave the hospital due to slowing down of the entire process.