Student Dissertation

Agency : Hospital Discharge Process; Waiting Time; Cash Patients; Discharge Management Framework

Objective : • To study the impact of the Discharge Management framework in the Columbia Asia Hospital, Yeshwanthpur Bangalore. • To compare the discharge process of the cash patients before and after the intervention of the plan. • To analyze the discharge process of the cash patients and problem areas in the last six months • To set the targets and focus areas for the coming months.

Background : 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, 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 : Quantitative pre-and post-interventional study. It was a 2 months study. The study area was 2nd and 3rd IPD floors, Columbia Asia Hospital Yeshwanthpur, Bangalore. There were two sets of the data. The data for the pre-interventional study was obtained from the HMIS. The post interventional data by direct observation of the discharge process and following up of the patients. The sampling technique used was the purposive sampling.

Findings : The average waiting time after the analysis of the six-month data was 167 mins. This was 107 mins more than the set target. The average waiting time taken after the intervention of the discharge management framework was 130 mins. This was 22% less than the pre-interventional average discharge time. The average time taken for the finalization of the discharge summary was 60 mins before the application of the Discharge Management Framework whereas average pharmacy clearance time of the past six months which is from Sep 2016 to Feb 2017 is 45mins. The average time taken for the finalization of the discharge summary was 58 mins. The average pharmacy clearance time after the intervention is 39 mins. The average waiting time for the clearance of the bill for the post interventional study was 33mins. It was 45% less than the time taken in the past few months.

Recommendations :The Columbia Asia 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