Perceptions Towards the Discharge Process in a Community Teaching Hospital

Abstract

Background: Discharge process in the hospital is lengthy and with low efficiency, especially in teaching facilities. Our objective was to identify perceptions towards the current discharge process and possible ways to improve it in a community teaching hospital in Las Vegas, NV. Methods: Quality improvement with cross-sectional survey questionnaire. Participants: 200 hospital staff (total possible participants) who were involved in the discharge process. 149 (actual participants) completed the surveys (response rate of 75[percent]) which included multiple choices as well as open ended questions; 95 nurses, 43 residents, and 11 case managers. Results were analyzed using the Chi-Square test. Results: 44[percent] of respondents believed that the hospital discharge process is efficient while 56[percent] did not. Frequent delays in discharge process from hospital were estimated often by 57.7[percent]. Easiest placements were home health (51.7[percent]) followed by hospice (19.5[percent]). The most time-consuming placements were skilled nursing facility (43[percent]) followed by acute rehab (22.8[percent]). The preferred method of contact regarding discharge process differed among roles. 41[percent] of nurse respondents listed voice calls while 54.5 [percent] of case managers and 44[percent] of residents documented text messaging (P-value [less than] 0.001). While most (61 [percent]) believed that multidisciplinary rounds are of value, the percentage of those who preferred it, differed among roles. 69.4[percent] of nurses favored multidisciplinary round versus 4.2[percent] who did not. This was 54.5[percent] vs. 27.2[percent] for case managers and 44.1[percent] vs. 30.2[percent] for the residents (P-value = 0.002). Conclusion: Discharge process in teaching facilities is considered fragmented, inefficient and different groups of health care personnel perceive it differently.