Student Dissertation

Agency : Hospital Discharge Process; Reduce TAT

Objective : • To understand the process flow of discharges in the hospital. • To find out the gaps. • To find out the reasons of delay in discharge process • To recommend measures that a reduce the delay

Background : Discharge from the hospital is the point at which the patient leaves the hospital and either returns home or is transferred to another facility such as one for rehabilitation or to a nursing home. Discharge involves the medical instructions that the patient will need to fully recover. Discharge planning is a service that considers the patient's needs after the hospital stay and may involve several different services such as visiting nursing care, physical therapy, and home blood drawing. Sakarkar defines “discharge as the release of an admitted patient from the hospital”. Discharge process is defined as the process of activities that involves the patient and the team of individuals from various discipline working together to facilitate the transfer of patient from one environment to another. The process comprises of clinical, financial, legal and administrative and recordkeeping aspects starts right from writing of discharge orders to settlements of all kinds of hospital bills is a time-consuming process; but if executed in an organized way with assistance from trained medical, para-medical and administrative staff it can be completed as per global standards or those prescribed by hospital accreditation boards like NABH at national level and JCI at the international level.

Methodology : Sample technique: Inclusion- All schedule (cash, TPA & corporate) are included. Exclusion- Discharges direct from emergency department are not included. Methodology: A pre-post study was done for all the discharge cases in the hospital and difference in TAT was recorded Study design: Interventional study Time frame: 7th February 2017 to 7th May 2017.

Findings : The percentages of patient discharges which met the TAT is increased to 8%. The average waiting time is also reduced after the intervention. Analysis of TAT for Planned Discharges, in case of Cash discharges after the implementation the TAT reduced to 25 minutes, similarly in TPA discharges after the implementation the TAT reduced to 24minutes & Corporate discharges after the implementation the TAT reduced to 20 minutes. Analysis of TAT for Unplanned Discharges, in case of Cash discharges after the implementation the TAT reduced to 40 minutes, similarly in TPA discharges after the implementation the TAT reduced to 1 hour 9 minutes & Corporate discharges- after the implementation the TAT reduced to 16 minutes.

Recommendations : The Medica Hospital like any other hospital is facing difficulties with the discharge process. The discharge of the cash patients requires strict monitoring and control for the effective results of the discharge management framework. This requires a focused approach and joint commitment from all the concerned departments. The process requires continuous reviews and corrective measures. The interventions done were helpful in reducing the TAT and continual monitoring of the same will help in sustaining the TAT


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