Centralized Discharge Process to Increase Patient Satisfaction and Safety

Purpose:
The Family Centered Care Unit (FCC-3) experienced a sharp decline in Patient satisfaction and a few “near missed' safety events in the 3rd quarter 2008. After reviewing all the impacting factors, a Discharge Coordinator Program (DCP) was created to increase patient satisfaction and patient safety.

Significance:
Postpartum women have much to learn in order to care for themselves and their newborns within their short hospital stay. In an FCC unit with a high patient turnover rate, the streamlined DCP promotes the effectiveness of patient learning as well as improve the efficiency of workforce management.

Strategy and Implementation:
The DCP removed a nurse from staffing whose main objectives are to provide an individualized plan of care for each patient, coordinate with the primary nurse to reallocate patient assignment and check all charts to ensure patient safety needs have been addressed. Additionally the Discharge Coordinator (DC) performs post discharge phone calls to gather timely feedback for practice changes. This program allows the primary RN to utilize their time with the patient more effectively without increasing the cost of manpower. Patients and families are more satisfied when education is tailored to their needs. The double checking system ensures no missing steps in patient safety. The post discharge phone call provides invaluable data and has led to a refinement in team safety rounding practices as well as alternate education methods. As the program evolves, it has been standardized and expanded to all FCC units to provide service 7 days a week for both English and Spanish speaking patients.

Evaluation:
The preliminary data shows an improvement in patient satisfaction survey. The excellence ranking has risen from 66.6 to 81.3 percentile in 2 quarters since its inception. There have been no serious safety events noted and timely discharges have been observed.

Implications for Practice:
This program is useful to units with high patient turnover rates. By effective re-arrangement of the nursing workforce, this program allows nurses to spend more time with their patients, ensures the quality of patient care and increases patient satisfaction and patient safety.