Student Dissertation

Agency : Hospital Discharge Process; In-Patient Discharge Process; IPD Department; Turnaround time; Evaluation

Objective : 1. To understand the discharge process at Sakra World Hospital-Bangalore. 2. To estimate the turnaround time for the discharge process at the hospital 3. To assess the average time taken to complete discharge process at various levels of the discharge event. 4. To address the problems for delay causing areas of discharge process

Background : Turnaround time is the period for completing a process cycle or time taken to deliver output once the process is submit to operate, often turnaround time tool is used to evaluate whether the processes are economically advantageous, making the most efficient use of time and materials. Discharge turnaround time can be defined as the interval from the time the consultant orders for discharge of the patient to the time physical walkout of the patient from the floor. Monitoring discharge turnaround time allows hospital to measure the efficiency of bed management and effectiveness of the operating process within the hospital.

Methodology : The study is cross sectional in nature and the data collection method is convenience Sampling. During the study both qualitative data like factors responsible for delay in discharge process, its impact on other process and quantitative data turnaround time for discharge process has been collected. The data has been collected through Various studies related directly or indirectly to the objective of the present study. The secondary data were collected from various sources that include journals, Articles, Reports of various surveys, and relevant websites quoted at the reference section. Secondary data was also obtained from HIS about various time of discharge. Primary data has been collected from 211 discharges with the help of tabulated TAT time assessment sheet which were filled with the real time during each discharge event by the hospital staff. The study area was different wards of the Sakra World Hosital,Bangalore.

Findings : Among the department wise Obstetrics and gynecology department and Orthopedics department Patients discharge process were lengthier. Although other departments namely Urology, ENT and Plastic surgery discharges found lengthier, probably they may be exceptional cases due to lesser sample size. Of 9 ENT cases the major cause of delay was at the insurance desk of which about 5 hours 10 minutes were spent on waiting for the enhancement process from the TPA and about 3 hours and 42 minutes were spent by the insurance desk. Of 59 ObG patients’ 44 patients were with the cash payment mode and average time taken to clear the bill by patient was 1 hour and 52 minutes and time lag between nursing station and discharge Secretary desk in transferring finalized discharge summary to nurse station was 54 minutes. Possible suggestion for the delay in time lag and improving the bill clearing time will be discussed in the further part. Among the 15 insurance covered and corporate payment mode patients there was a delay in updating the Authorized insurance status to billing department by insurance desk of about 1 hour 49 minutes. About 1 hour 10 minutes were taken by patient to clear bill among 8 cash payment mode patients of Orthopedic department and about 55 minutes and 50 minutes were time lag between nurse stations and Discharge secretary desk and nurse station and pharmacy respectively.

Recommendations : The present study aims at understanding and analyzing the discharge process at Sakra World Hospital- Bangalore, by using the turnaround time as a tool for evaluation of efficiency discharge flow. The study reflects a customized analysis of discharge process at the hospital in consideration of Various departments which were directly involved in the discharge process. The study point-outs the possible Delay causing area in discharge process and recommends suggestions to overcome the delay.