Early availability of laboratory results increases same day ward discharge rates
-
Michael P. Cornes
,
Graham Danks
Abstract
Background:
Delayed discharge reduces hospital efficiency and inconveniences patients. Most hospitals discharge in the afternoon, whereas the most common admission time is mid-morning. Consequently, new patients wait for the beds of patients who are fit to be discharged. Earlier discharge may, therefore, improve patient flow. We investigated the impact of early phlebotomy with early availability of laboratory results on patient discharge rates and discharge time.
Methods:
Discharge rates, discharge time and sample turnaround time were assessed before (1 October 2014 to 31 December 2014) and after (1 October 2015 to 31 December 2015) introduction of earlier phlebotomy with availability of laboratory results prior to the ward rounds on two surgical wards.
Results:
Following the intervention, over 95% of results were available before 8:30 am in 2015 as compared to less than 1% in 2014. Specimen turnaround times were similar in both study periods. Even after adjustment for age, gender, admission type and length of admission, the same day discharge rate was higher in 2015 compared to 2014 (60% vs. 52%; p<0.002), but time of discharge was unchanged.
Conclusions:
Early availability of blood results prior to ward rounds increased ward discharges but did not affect discharge time.
Acknowledgments
Helen Latunji Royal Wolverhampton NHS Trust Information department Royal Wolverhampton NHS Trust Phlebotomy Team.
Author contributions: MC, GD, RG, CF and SE designed the study. MC coordinated the study. Data were collected by ER, JT and MC. GD conceived the study. Data analysis was performed by MC and MJ. The manuscript was drafted by MC, RG, MJ and CF. All authors reviewed and added to the final draft. All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Guarantor: RG.
Research funding: This quality improvement project received no grant from any funding agency in the public, commercial or not-for-profit sectors. The authors received no financial support for the authorship and/or publication of this article. The Public Health Policy Evaluation Unit at Imperial College London is supported by funding from the NIHR School of Public Health Research.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
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©2018 Walter de Gruyter GmbH, Berlin/Boston
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