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What’s actually keeping hospitals from early discharges?

Case Management Weekly, January 8, 2008

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According to Bud Pate, REHS, practice director for The Greeley Company, a division of HCPro, Inc., in Marblehead, MA, there are four main barriers that prevent hospitals from discharging patients earlier in the day.

Barrier one: Who's in charge?

Most hospitals are dealing with more complex patients who often see multiple physicians. A patient may enter the hospital through family medicine, but the hospital may later transfer him or her to cardiology, so now staff members must make a split decision: where does the discharge come from and who makes the decision?

Barrier two: What tests do patients need?

Identify possible discharges the day before and try to identify the controlling physician and what type of testing may be necessary.

Barrier three: What type of posthospital care?

This is a question you should ask on the first day of a patient's admission and every day that the patient remains in the hospital.

Barrier four: Will the physician make his or her rounds in the morning?

More often than ever, physicians are practicing at multiple locations and spreading care from the inpatient hospital to outpatient surgery centers and physician offices. These logistics sometimes make it difficult to discharge patients. Under these circumstances, be proactive and do the discharge work the day before the actual discharge.

Source: Patient Access Weekly Advisor, HCPro, Inc.

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