Discharge Huddle Augmented by Technology Improves Efficiency of Discharging Patients into Continuum Partners

Purpose:
To determine if the combined modalities of a discharge huddle and technology including iPads and cellphones with texting capabilities would increase discharges into our continuum partners (Inpatient Rehab, Homecare and Outpatient rehab) and communication among team members.

Significance:
Baseline chart audit results revealed that only 15% of stroke patients were discharged into Vanderbilt's continuum partners. In addition, from extensive process mapping, we determined that each discipline was functioning in a silo with disjointed communication among all team members.

Strategy and Implementation:
We tested this hypothesis on the Neurology Stroke Service (NSS). Each Case Manager /Social Worker/discharge planner was provided a cellphone with texting capabilities. In addition, they, along with Physical, Occupational and Speech therapists were provided with tablet technology. The remainder of the team included liaisons from each of our continuum partners and the charge nurses. Daily multidisciplinary huddles were initated with the purpose to identify any barriers to discharge and facilitate discharge planning. Data was collected daily during the study to include, length of stay, discharge disposition and staff satisfaction and utilization of the iPad and cellphone.

Evaluation:
Referrals into our partners increased from 15 to 37% and LOS was decreased from 5.5 days to 4.3 days. Team members agreed that the iPad and phones had increased their efficiency and were utilizing them routinely (defined as 50-100% of the time)resulting in patients being discharged more efficiently.

Implications for Practice:
We conclude that the combination of the discharge huddle and providing state-of-the art communication technology increased referrals into our continuum partners, decreased length of stay and communication among team members.