Title : A discharge lobby reimagined with impact on patient engagement
Abstract:
Faced with continued patient surges in the emergency room, increased number of patients left without being seen (LWBS), increased boarding times, with declining patient satisfaction scores, the Northwestern Medicine Central DuPage Hospital (CDH) administration recognized an innovative opportunity to develop a discharge lounge (DCL) aimed to impact these outcomes. At CDH, the average daily patients LWBS in 2022 was 11 patients daily or 5%, and the average turnaround time (TAT) from assigned to occupied was 79.1 minutes. CDH, identified inefficiencies in patient flow from the ED to the inpatient units. To achieve our care delivery strategic goals, the DCL was implemented in January 2023.
Mary Fran led a multidisciplinary group that was formed to create the vision. Initial hours of operation were limited. It was determined that a dedicated attendant, would provide consistent structure, and a proactive “pull” approach would prompt participation of patients. With the use of consistent staff and scripting, discharge rounding would also be incorporated into the DCL experience. Patient feedback would be escalated by the DCL attendant to the patient’s corresponding unit leader to perform a follow up call. Patients would be greeted, offered amenities and scripted questions used to inquire about the level of satisfaction of their hospital experience. The discharge rounds included, understanding of their instructions, awareness of new medication side effects, and satisfaction with responsiveness of staff. It also included education on use of “My Chart” as a resource for the patient.
Within 5 months, 33% of discharged patients or 2042 patients utilized the DCL. Outcomes were favourable with 8% improvement of discharges before 4pm, LWBS decreased from avg of 5% to 3%, TAT decreased to an average 73 minutes, and CDH noted a 10-point increase in the patient engagement score for patients who received a discharge round in the DCL. Due to these outcomes, the DCL is anticipated to expand to 5 days a week. Major lesson learned was the DCL had impact on patient satisfaction.
Audience Take Away Notes:
- How to logistically launch a discharge lounge to improve efficiency and hospital flow.
- Improve emergency room metrics for left without being seen (LWBS).
- Improve patient engagement through participation in the discharge lounge experience.
