The discharge lounge at Texas Health Harris Methodist Hospital Hurst-Euless-Bedford is the last place most patients see before they go home, but it’s much more than just a place to wait for a ride. The lounge team helps them leave sooner and better-informed.
Before patients go, the discharge lounge team examines their charts thoroughly and reviews discharge instructions. The patients have to be able to recite the answers to the “Five Ds of Discharge:” Diagnosis, Drugs, Doctor, Directions and Diet.
“The patients need to answer all the questions,” said Tracy Stowe, R.N., B.S.N., manager, discharge lounge, clinical decision unit and float pool. “If they can’t, the discharge lounge nurse needs to go back and review that part of the instructions.”
Five Ds
While the discharge lounge concept itself is not new, the Texas Health HEB team has hardwired the “Five Ds” into practice. Like their counterparts at Texas Health Harris Methodist Hospital Fort Worth, they have been operating successfully for years.
“We really are the last set of eyes,” said Charolette Harfield, M.S.N., R.N., NEA-BC, manager of the resource team at Texas Health Fort Worth’s dismissal lounge, which has operated since 2015.
At Texas Health HEB, where the lounge has operated since 2013, they’ve seen increased patient satisfaction related to discharges.
When the lounge first opened, the overall hospital discharge questions asked of patients were ranked at 39% and in 2019 the discharges overall are in the high 80s.
The discharge lounge was able to measure readmission rates in January 2017 with the help of a statistician and the data showed that if the patients were discharged from the lounge there was a 5.3% decrease in readmission rates. They have not been able to measure this since but are currently working with Care Connect 1 to receive a monthly readmission report.
The discharge lounge was also the driver of the discharges by 2 KPI in 2018. Through its work, the Emergency Department saw an overall decrease in the time the patients spent waiting on a bed by 40 minutes as shown on the dashboard.
The lounge handles 65 percent of the discharges, which works out to an average of 20 per day.
Texas Health Fort Worth’s discharge lounge handles between 350 and 500 discharges a month.
More time for floor nurses
Both lounges help free up nurses on the floors as well as hospital beds for incoming patients.
“I also believe it functions as a safety catch,” said Lori Williams, R.N., B.S.N., director of nursing administrative services at Texas Health HEB. “The discharge lounge will catch things the floor nurses might not be able to catch because of their floor work.”
The discharge lounge team members are “experts in admission and discharges,” Lori said. “A lot of the floors will send new nurses to the discharge lounge, where they show them how to review the chart so when they get a discharge they know how to do it. Even some of our older nurses have really learned more than what they knew.”
By Judy Wiley • Posted August 27, 2019
