Abstract
Background: Patient care management and throughput are directly affected by the effectiveness of interdisciplinary communication. Discharge navigation begins at in-patient (IP) admission and continues until discharge. Therefore, the healthcare team is focused on appropriately mitigating barriers to promote safe and timely discharge. The motivation for an efficient discharge process has been a top priority amongst the U.S. COVID-19 epidemic. Purpose: Utilizing an interdisciplinary approach to care management proves to reduce the length of stay (LOS) (Patel et al., 2019). Thus, given the rise in acute IP admissions, our team established goals focused on early identification and management of barriers commonly encountered by stroke patients. Methods: Stakeholders included leadership, providers, nurses, ancillary staff, and Discharge Navigator implementation. The aim is for discharge navigation to use a best-practice approach to “bridge the gap” and increase interdisciplinary communication through multidisciplinary progression rounds, interdisciplinary bedside rounding, and digital formats. The process of initiating discharge conversations on admission and intermittently throughout the day has resulted in expedited throughput transition. Results: Improved readiness for discharge played an essential role in decreasing stroke patient LOS and increasing patient satisfaction. Patient satisfaction (PS) data indicates that we are below the benchmark for several indices. From (2020 to 2021) average satisfaction scores for nurse and doctor communication increased from 70.1 to72.3% and 72.5 to 77%, respectively. Satisfaction with discharge information increased from 86.3 to 88.4%. In addition, LOS data indicated decreased LOS for stroke patients with minimal complications, including DRGs 069, 063, and 061. The average LOS decreased from 2.7 to 2.1, 2.9 to 1.8, and 8.8 to 8.1 days, respectively (April-July 2020) to (April-July 2021). Conclusions: Quality improvement initiatives, including a throughput-focused team to “drill down” on discharge barriers, has shown decreased LOS, increased PS, and accountability to stroke patients.
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