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Planning an Efficient Discharge Process in a Green Filed Project through Study and Analysis of the Bottle Necks Involved

  • Natasha Singh
  • Agency : Greenfield Project, Discharge Process, Bottlenecks Involved
  • Objective : The  main  objective  is  to  study  the  factors which affect average waiting time and timely discharge. To determine the source of error and the reasons for its occurrence. Identifying rework loops, non-value-added steps. To plan out an effective and efficient flow of discharge process in new hospital setup.  
  • Background : The  discharge  process  is  a  critical bottleneck for efficient patient flow. Slow or unpredictable discharge translates into a reduction in effective bed capacity and admission process delays
  • Methodology : The methodology includes Data collection through Primary data through Brainstorming, Intervies and FGDs. Secondary data by Literature review, Case studies review, Internet search, Research papers, reviewing the process of existing hospitals. Qualitative analyses were done.
  • Findings : Hospital discharge process is characterized by fragmented, non-standardized, and haphazard care which further leads to lengthy discharge and admission cycles. Incomplete information on transfer between services. Poor communication and poor follow-up care. Too many people involved in discharge decision. Some providers are not informed of discharge decision. Too many people involved in  discharge  notification.  Inappropriate  placement, Chaotic, repetitive process with various gaps.  Delays in discharge  process  as  well  as  inappropriately  early discharge which further excludes any input from patient regarding  their  perceived  readiness  for  discharge. Prolonged hospitalization. Re-checking of the entries of consultant visits have to be done for each bill. This takes a lot of time as the doctor has to be contacted many times. This further adds up in delaying the whole process. Its takes a long time to process the bill of patients with long length  of  stay  in  the  hospital-(About  2-3  months)  as rechecking of all records has to be done. This affects the process time of other bills as well. The discharge summary printout is taken out only when the bill is taken out from the billing department. This result in wastage of time and the discharge process comes to a hold till the time the bill prints out is taken out.  Poor communication between the administrative staffs and the medical team or between the patient party and the hospital itself. Lengthy discharge and admission cycles arises chaotic situation and repetitive actions.
  • Recommendations : There should be a cash counter on each floor, taking care of their respective specialties. Roles and responsibilities should be clearly defined. Discharge is an actively managed process and its important that it begins at the point of admission (if not before, e.g. elective admissions with agreed care pathways).
To determine the source of error and the reasons for its occurrence. Identifying rework loops, non-value-added steps.