An Audit on Discharge Process in a Tertiary Care Hospital

Abstract

Discharge from a hospital is a process when there is transfer of care of a patient from an inpatient environment to another community or domestic environment. Delay in discharge leads to patient dissatisfaction, bed shortages, and postponement of elective admissions and procedures. National Accreditation Board for Hospital has set a limit for the discharge process, 2–3 h for cash patients and 3–4 h for insurance patients. In this Audit, we aim to assess the efficacy of the discharge process in a tertiary care hospital and also to analyze the steps that caused the delay and suggest possible remedies. This was a single observer Audit carried out in a tertiary care center between June and August, 2022. We audited the discharge process of 100 surgical patients from our hospital. Data was collected in real time at bedside, in the nursing station and also from the Electronic Medical Record system. We audited 100 discharge processes of which we had 26 patients who paid by cash and 74 patients whose bill was settled by the insurance companies. It was noticed that the discharge process was delayed in 40 patients of which 8(20%) delays were in the cash group and 32(80%) delays in the insurance group. Maximum delay in both groups was because of delay in indenting medications, intimation of discharge on the system and in handing out the discharge summary. The discharge process consists of various procedures which need coordination amongst various departments. Reviewing this process helps us in identifying and rectifying delays that are caused by the hospital in order to hasten the discharge process.