283 Delayed Discharge-a Pitfall for NHS; Can We Improve?

Abstract

Abstract Aim Identify reasons for discharge delays in a tertiary care hospital and find areas of improvement. Method Data were collected for seven days, and all inpatients (Elective and Emergency) admissions were included. Patient's demographic data, length of hospital stay, and discharge data were entered on Microsoft Excel and analysed using SPSS. Results Out of 102 total patients, 48 (47.1%) were male and 54 (52.9%) females. Mean age was 60.5 years (min 20 max 91). Clinical frailty score (CFS) was not calculated in more than half of the patients (n=55, 57.4%). 47(46.5%) patients had polypharmacy. 61(59.80%) patients did not have a documented Expected date of Discharge (EDD). Median hospital stay was 10 days (1–161 days). 27(26.47%) patients had delayed discharge (mean 4.93 days, median 1 day). Reasons for delay included unavailability of rehab bed (n=5, 4.9%), stoma nurse review (n=6, 5.88%), and awaiting bloods, diabetic control or discharge hub planning (n=3, 2.94%). Delayed discharges do not seem to be affected by polypharmacy (p=0.067), DNACPR (p=0.926), frailty score (p=0.761) or gender (p=0.518). However, Patients aged 65 or above were more likely to have delayed discharge (p=0.037). Conclusions Delayed discharge is more likely in over 65years. We recommend early identification of at-risk patients. Possible interventions to avoid discharge delays are EDD, pre-emptive preparation of discharge letters, early morning bloods and training of ward nurses for stoma care.