ABSTRACT
BACKGROUND: In an inpatient setting, aspects of discharge planning are often left to the provider's memory, leading to errors, inefficiencies, and avoidable costs. METHODS: A multidisciplinary team of oncology practitioners used process improvement methodologies to redesign the discharge planning process. INTERVENTIONS: The primary intervention was an evidence-based discharge planning tool, called the discharge navigator, used from admission through discharge. RESULTS: Thirty-day unplanned readmission rates decreased by 29.0% from preimplementation (March 2017 through August 2017) to postimplementation (September 2017 through March 2020). The percentage of patients discharged before noon increased 76.2%. A comparable service not utilizing the intervention saw lesser or no improvement in these measures. CONCLUSION: The tool provided a systematic approach to discharge planning. Key design elements included a centralized location within the electronic health record and an electronic shortcut to populate the tool. Although developed for a specialized population, most elements are applicable to any hospitalized patient.
Subject(s)
Patient Discharge , Patient Readmission , Humans , InpatientsABSTRACT
We implemented a guideline for appropriate acid suppressant use in hematology-oncology patients. This intervention resulted in a sustained reduction in proton pump inhibitor (PPI) use without an increase in rates of gastrointestinal bleeding. Practice guidelines are effective in reducing PPI use, which is associated with risk of Clostridioides difficile infection.
