Using a Discharge Checklist Across the Interprofessional Team to Improve Discharge by Noon Rates

Delays in patient discharge (DC) from acute care units can disrupt a hospital’s ability to transfer patients across settings of care within the healthcare facility, such as the emergency department and intensive care units. Hospitals have begun implementing a goal to improve discharge by noon (DBN) rates on acute care floors in order to open up those beds earlier in the day to enhance throughput. Studies have shown that using a DC checklist to identify and document completion of DC associated tasks able to be completed the afternoon or evening before anticipated day of DC can improve DBN rates. The scholarly project was a pre-intervention/post-intervention comparison project. The purpose of the project was to evaluate whether adding a standardized checklist completed by the interprofessional care team prior to the anticipated day of DC would improve the percentage of patients DBN without increasing the average length of stay or percentage of 30-day hospital readmissions. This project was conducted on two inpatient acute care units specializing in the care of cardiac and vascular patients in an academic medical center located in southeastern United States. The sample consisted of 73 patients discharged by the acute cardiology service. DBN rates in the intervention group improved from 2.3% at baseline to 10.0% post-intervention. No statistically significant differences in the LOS were found between the control (4.35 days) and intervention group (4.27 days). When compared to the control group, the percentage of 30-day hospital readmissions increased in the intervention group, 11.6% to 16.7%. An interprofessional DC checklist may improve DBN rates in patients admitted to an acute cardiac service, yet caution should be taken due to a potential increase in 30-day readmissions.