Study of discharge process of patients admitted in inpatient department of a tertiary care hospital of north India with a special focus on reducing the waiting time
Journal Title: International Journal of Medical and Health Research - Year 2018, Vol 4, Issue 7
Abstract
Introduction: Hospital discharge plan process comprises of clinical, financial, legal and administrative and record keeping aspects, starts right from writing of discharge orders to settlements of all kinds of hospital bills and is a time consuming process; but if executed in an organized way with assistance from trained medical, para-medical and administrative staff, can be completed as per global standards. Methodology: The study was carried out in General medicine and General Surgery wards of inpatient department of SKIMS. It was an observational type of study where in all the patients who got discharged in the said wards from 10am to 4pm daily (Except Sundays) were observed for their discharge process and a semi structured questionnaire was administered in all the discharged patients’ relatives about the discharge process including time taken for its completion and reasons of delay thereof. Results: A total of 710 Discharged patients were observed during the study period which includes 417 patients from General surgery department and 293 patients from General medicine side. The results show that the average time taken for discharge process was 240 minutes for those who had a planned discharge and had to pay out of pocket (Self- Payment). It was 255 minutes for those who had been discharged against medical advice (DAMA) while it was 270 minutes for below poverty line (BPL) patients who had to exempt hospital charges. The results also show that among all discharged patient’s relatives observed, majority (54%) felt that their discharges were delayed due to non -availability of resident doctor for preparing the summaries while 23% considered long waiting time outside MRD counter as the main reason for their delay. Conclusion: Time and tedious discharge procedure, also eventually contributes to patient dissatisfaction. All departments involved in the discharge process should be adequately staffed, depending on patient load in the hospital. Hospital administration should themselves carry out a periodic time motion studying all concerned departments and identify the reasons for the delays and difficulties in implementation of procedures. Hospital administration should also take feedback from patients about services including discharges as an ongoing activity.
Authors and Affiliations
Shahnawaz Hamid, Farooq A Jan, Haroon Rashid, Humera irshad, Tufail Ahmad
Keywords
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