Hospitals in pursuit of excellence

Early Discharge Times in OB

Labor and delivery departments are busy places. At New York-Presbyterian, providing appropriate bed placement is part of creating a safe environment for patients and families. A initiative at the New York-Presbyterian/Morgan Stanley Children?s Hospital aimed to double the percentage of mothers and newborns discharged by 2 p.m. Changes implemented include developing a real-time demand capacity structure for obstetrics, creating round-the-clock discharge expectations and changing physician workflow so circumcisions are performed before discharge day. Other changes involved behavior modeling and coaching with charge nurses, focusing rounds on discharge "milestones" and publishing weekly performance reports. Outcomes show a 250 percent increase from baseline for patient charges by 2 p.m. in the nursery. And the speed of the discharge process improved 5.1 points in 13 months on Press Ganey evaluations. "Vital elements for success were building partnerships between medical teams, nursing teams and support services and having engaged and committed unit-level leaders," says Patti Craig, R.N., quality and patient safety improvement manager. Contact her at craigpa@nyp.org.