Discharging patients from hospital is a complex process which requires multiple professionals and processes which takes time. When hospitals are operating at full capacity, late afternoon discharges can contribute to emergency department overcrowding which is associated with poorer patient outcomes and decreased patient satisfaction.
By discharging patients earlier in the day, this can lead to reduction in bottlenecks and improve patient flow.
Leeds Teaching Hospital Trust has an aim to reduce length of stay for each patient by half a day and discharge 60% of patients by 3pm.
Working as part of the discharge collaborative, discharges were analysed and potential avoidable causes for delays to discharge identified.
A series of PDSA cycles were developed collaboratively resulting in two step improvements across the trust.
Click on the image below to read and download the full project report
Testimonials from staff and patient partner:
MM- Discharge Coordinator in Trauma and Related Services- “Our teams are dedicated to ensuring out patient group have a seamless transition from hospital to home, focusing on early discharge times. We have worked hard and in collaboration with all the multidisciplinary teams at MDT we have improved these time frames, which is now reflected in our CSU step improvements and our overall patient experience’
SE- Junior Doctor in Renal/Medicine- “I have thoroughly enjoyed my experience of working with the discharge collaborative, especially identifying, and addressing areas of improving patient stay/discharges. My leadership skills have developed throughout this process, especially in regards to supervising/supporting more junior colleagues.”
KS- Junior Doctor in Elderly Medicine- “The discharge collaborative provides an opportunity for us, as junior doctors, to engage in quality improvement and understand the volume of hard work undertaken by the multidisciplinary team within the Trust to enable safe, early discharge; improving patient care. I have seen firsthand the positive experience patients have had by being discharged earlier in the day. It also improves patient safety as early discharge enables new patients to arrive to the ward for review and clerking earlier and reduce out of hours workload’.
CG- Junior Doctor in Oncology- “The first time I was introduced to the discharge collaborative was as a FY1 in orthopaedics. It was an incredibly busy job and discharges could be so unpredictable; it would make an already busy day feel impossible to manage. However, simple interventions shared by the discharge collaborative and its enthusiastic team eg a discharge board and highlighting discharges at the morning huddle made a huge improvement in planning our work for the day and enable early discharge. Now, a few years later it is a pleasure to work with the team to try and improve discharges in other departments. It’s amazing how much we can do, despite obvious challenges like understaffing, to ensure our patients have a great experience whilst an inpatient and also when they are discharged.”
DM- QI Patient Partner-“ My name is DM and I am a QI Patient Partner at LTHT. Since January 2021 it has been and is my pleasure to be part of the Discharge Collaborative. It meets fortnightly and has representation from all CSUs. Under the inspired leadership of Dr Anna Winfield this Collaborative has worked hard and consistently to increase the percentage of patients who should be discharged by 3pm, especially during the highly pressured times from the Covid pandemic to today. I have found this initiative to be an excellent example of team work in action, building on the various initiatives to better manage bed occupancy and thus contributing effectively to The Leeds Way”.
Click on the image below to read and download and editable version of the discharge certificates
