Efficient
- Develop discharge plan at time of admission and book in resources e.g. alternative accommodation, community supports etc
- Conduct consultant rounds early in the day to allow time for decisions to be carried out during office hours when plentiful staff available
- Drop off lab and imaging requests early in the day
- Request consults early in the day
- Anticipate discharges 48 hours in advance
- Establish discharge criteria the evening before morning round
- Request discharge medication the evening before and book transport for early pick up
- Request morning blood specimens ‘urgent’ for potential discharges
- Let ward team know of plan in advance e.g. ward nurse, ward clerk
- Begin ward rounds on patients anticipated to be discharged that morning
- Send patients to discharge lounge prior to transport
Inefficient
- Attempting to form discharge plan the night before
- Conducting rounds at the end of the day when it is too late to do anything meaningful
- Leaving important work to be done at the end of the day
- Not being clear about discharge criteria
- Waiting until next consultant ward round to discharge patient
- Ordering discharge drugs at last moment
- Placing review of patients and lab tests at the end of day
- Conduct ward round in bed order or on long-stay patients first
- Hold stable and dischargeable patients on the ward prior to transport