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Authors

  1. Feldman, Sue S. PhD, MEd, RN
  2. Kennedy, Kierstin Cates MD, MSHA, FACP, SFHM
  3. Nafziger, Sarah M. MD, MSHA
  4. Orewa, Gregory N. MSc, MBA, LNHA
  5. Kpomblekou-Ademawou, Enyonam LSSGB
  6. Hearld, Kristine Ria PhD
  7. Hall, Allyson G. PhD

Abstract

Background: Delayed discharges can be a systemic issue. Understanding the systemic factors that contribute to discharge inefficiencies is essential to addressing discharge inefficiencies.

 

Purpose: This article reports on a Lean Six Sigma approach and the process to identifying inefficiencies and systemic barriers to early discharge in a large US academic medical center.

 

Methods: A qualitative methodology guided this project. In particular, direct observation methods were used to help the project team identify factors contributing to discharge inefficiencies.

 

Results: Overall, findings suggest that establishing consistent multidisciplinary team communication processes was a contributing factor to reducing the inefficiencies around discharges. On a more granular level, key barriers included disparate communication systems, disruptors (specifically Kaizen bursts), and unique role challenges.

 

Conclusions: This article provides a framework for addressing discharge inefficiencies. Because the output of the process, a critical contributor to the overall outcome, is often not analyzed, this analysis provides value to others contemplating the same or similar process toward discharge efficiency.