Abstract of Dissertation

Keyword : Hospital Discharge Process; Inpatient Department; Delay in Discharge Process; Patient Admission Process; Patient Satisfaction

Objective : • To study the discharge process with reference to time and steps involved. • To identify the reasons leading to delay in discharge process.

Background : Patient discharge process from hospital is a significant process and determines the working of in-patient department. Any delay in discharge process leads to delay in patient admission process, thus disturbing smooth in-patient flow of hospital. Over stay of patient in hospital increases the utilization of hospital resources. This also affects the patient satisfaction level during hospital stay.

Methodology : A prospective study was done from 13 February 2017 to 13 May 2017 in Inpatient (Pediatric Intensive Care Unit, Neonatal Intensive Care Unit, Wards) departments at SRCC Children’s Hospital (A Unit of Narayana Hrudayalaya Ltd.), Mumbai. An observational study was done on steps involved in discharge process of 100 patients. The patients to be discharged and process involved were studied, and the discharge activity was followed from the time of intimation by consultant to the time of discharge.

Findings : The sample consists of maximum number of patients of bill clearance by individual cash payment mode. The percentage of patient discharge before 11:00 am in planned discharges is 51%. The cause of delay in discharge process was mainly due to delay is discharge summary and billing, which was 32% and 24% respectively. There was high percentage of delay in patient discharge nurses(12%) and also due to delay in bill clearance by attendents(15%). Average TAT for individual cash payment patients is 5 minutes more than required time. In case of TPA payment it is 15 minutes above the required time.

Recommendations : From study, it is concluded that there were few gaps a in discharge process. The patients to be discharged consisted of maximum number of cash payment patients, followed by TPA payment mode. More than half of the patients were discharged before 11:00 am. Major reason for delay in discharge process was due to delay in discharge summary and billing. The average turnaround time for discharge of patients remained slightly higher than the required/ideal time.