Knowledge Bank

Discharging patients from the hospital setting requires extensive planning to ensure they are prepared to maintain their wellness outside the hospital. Delays in discharging patients are costly to organizations and patients. This Doctor of Nursing Practice (DNP) quality improvement project aims to help identify patients ready for discharge by using an electronic medical readiness tool to prepare patients for discharge. At a Midwest pediatric hospital, the previous process of utilizing a paper readiness tool had a low completion rate. This project used Lewin’s Change Model and the Plan, Do, Study, Act model to implement a transition from the current process of using a paper medical readiness tool to an electronic form of the tool. In addition to the tool, incorporating a discussion of the medical readiness of each patient’s progress in the interdisciplinary rounding was needed to increase awareness of patient progress towards discharge. The tool, combined with daily awareness during interdisciplinary rounding, was expected to have patients discharged without delay within two hours of being identified as medically ready. During the 12-week implementation period, a total of 64 patients were discharged. Of those, 78% were discharged within two hours of being identified as medically ready. This was attributed to the communication and consistent review of the discharge progress during interdisciplinary rounds. Although the nursing rate of completion of the electronic tool was only 28%, delays in discharge were not linked to tool completion. These findings suggest that a readiness tool supports discharge planning in combination with active interdisciplinary communication.