Student Dissertation

Agency : Hospital Discharge Process; Discharge Process; Turnaround Time; Factors Causing Delay

Objective : • To understand the discharge process at Zydus Hospitals, Ahmedabad. • To assess the turnaround time for the discharge process at the hospital. • To analyse the factors causing delay at each step of discharge process. • To improve the discharge process by carrying out intervention, hence, reducing Turnaround time.

Background : In this study, hospital discharge flow of ward patients is understood by a Baseline Study, and the various delays are identified. After brainstorming few of the interventions are finalized and implemented as well as new initiatives were taken to fasten up the process and later its effectiveness was checked by comparing the results.

Methodology : • Study Type- Interventional study • Study location- Zydus Hospitals, Ahmedabad. • Study duration- 1st March to 30th April 2017. • Sampling Method- Convenient Sampling. Samples were under consideration of following inclusion and exclusion criteria. Inclusion: ? All the inpatient discharges. Exclusion: ? Discharge process of casualty admissions, daycare process/procedure admissions, newborn admission, ICU admission, DAMA and Death cases were excluded from the TAT data collection. ? Patients discharged at night and on Sunday are excluded. • Sample Size- Total number of discharges were 875, out of which 421 discharges in pre-intervention phase and 454 in ost-intervention phase, which is about 50% of the total discharges occurred during study period. • Data Collection Method- Data was collected by observation of the discharge process at each level, HIMS (HINAI) of Zydus hospital, and interviewing the staff. A tabulated TAT assessment sheet was made in which data were entered. • Study Respondents- The departmental staff who were directly involved in the discharge process were considered. • Data Analysis Technique: Firstly, a baseline study was done to find out the TAT of March 2016 and factors causing delay in discharge process. This data was then converted into excel sheets and various analysis was done and problem areas were found out. Then with help of this baseline data, the possible reasons of delay were analysed, and possible intervention ideas were identified discussion with brainstorming sessions with the management. Following the experimentation phase, the data were collected, and comparison was done to check the effectiveness of the interventions.

Recommendations : The present study aimed at understanding and improving the discharge process at Zydus Hospitals by using the turnaround time as a tool for evaluation of efficiency discharge flow. The study pointed out the possible delay causing areas in discharge process. In the post-intervention phase, the interventions were made, which lead to a considerable improvement in Turnaround time of discharges in the post-intervention period, but still there is scope of improvement in various steps of discharge process.