Critical Path Network
Special discharge area frees up beds
Use of unit improves throughput, ends ED backups
Faced with a high census and backups in the emergency department, Bay Medical Center in Panama City, FL, created two discharge areas where patients who were waiting for transportation to home or a nursing home could wait, freeing up much-needed beds on the units.
During high census times when the hospital is full, patients who are being discharged to a nursing home are transported to a special discharge unit, created in what used to be the hospital's emergency department.
Patients who are appropriate for the unit don't need acute care but do still need some care, such as IV antibiotics or help going to the bathroom.
The seven-bed unit is staffed by emergency department personnel, usually an LPN. It is equipped with hospital beds, bedside commodes, and doors that shut, allowing the nurses to change the patients' dressing, administer medications, and take care of other patient needs.
"Waiting times for transportation to a nursing home can be several hours or longer. There are only two nonemergent medical transport companies in our area. Two acute care hospitals, a rehab hospital, and Medicaid transportation programs are all in competition for their services. If one company is on a long-distance run, waiting times are very long," says Delilah Dennis, RN, manager of resource management.
The hospital also uses the discharge unit for isolation patients, giving housekeeping a head start on cleaning and disinfecting the rooms.
The case managers on the unit are responsible for transferring appropriate patients to the discharge unit. They are accountable for making sure that a bed is available in the nursing home, arranging transportation, and helping transport the patient to the unit.
"Some days, the unit isn't full, but during high census time, it helps free up beds," she says.
Patients who are well enough to sit in a chair and walk to the bathroom may wait for transportation in the ambulatory discharge lounge, located in the central admissions area near the hospital's valet parking lot.
The lounge has a private bathroom and is furnished with a telephone and a television set. It's staffed by transporters who sit at a desk and log patients in. Patients who stay in the lounge through mealtime receive their meals in the area.
"Sometimes patients are ready to go home early in the day but their family members can't pick them up until later. This frees up a bed for incoming patients and gives the discharge patients an area in which to wait," Dennis says.
Family members love the location near the valet parking lot because they can drive up and pick up their loved ones, Dennis says.
"Our hospital is 50 years old and it's landlocked. Parking is a nightmare, and families spent a lot of time circling the parking lot and often had to park a long way away when they picked up the patients," she says.
(For more information, contact: Delilah Dennis, RN, Manager of Resource Management, Bay Medical Center, e-mail: [email protected].)
Faced with a high census and backups in the emergency department, Bay Medical Center in Panama City, FL, created two discharge areas where patients who were waiting for transportation to home or a nursing home could wait, freeing up much-needed beds on the units.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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