Hospitals and health systems continue to struggle with capacity and patient flow issues as patient censuses continue to rise. These same throughput congestion problems have made it more challenging to sustain an optimized care and satisfaction experience for patients. Solutions for this twin conundrum facing healthcare providers involves combining operational capacity management technology and collaborative care relationships between facilities across the country, and even around the world.
However, as the benefits of these solutions outside the four walls of a hospital are realized over time, there are also answers to unclogging patient traffic while keeping patients happy within the four walls of a single or multi-campus facility. They can be found in the overlooked, underutilized, or mis-utilized spaces within a hospital that can, at a minimum, be repurposed or redesigned and rebuilt if space is available. These spaces can be transformed into Discharge Hospitality Centers (DHCs), also known as Discharge Hospitality Lounges or Discharge Cafés. DHCs have recently increased in popularity, partly as a capacity-freeing response in the wake of COVID, but also because of further outcomes data from long-established DHCs that have demonstrated how well they work. (See DHC outcomes results below.)
Finding the elusive "open bed" is the laser focus priority of every healthcare facility. Anything that can be done -- without sacrificing patient care or safety -- to locate that available bed faster for patients coming through the ED (Emergency Department) or for a scheduled procedure has become the key to unlocking capacity. Hospitals and health systems that have flagged and improved patient flow process deficiencies, with the support of capacity management and real-time location system (RTLS) operational platforms, have been able to quickly identify open beds and/or accelerate decision making for opening up bed capacity at any step across the in-patient care journey. In fact, facilities that have been able to streamline bottlenecks in the discharge process at the back end of the patient flow progression, utilizing capacity management technology, can open bed access at front end admissions and even streamline patient volumes boarded in the ED.
However, the “last mile” of the discharge process -- from the time a patient’s discharge order is formally recorded in the system to their time spent in the DHC to their departure from the facility -- can become a last chokepoint of throughput inefficiency and patient dissatisfaction. Moreover, DHC patient departure delays can potentially work against the discharge and early discharge milestone efficiencies achieved utilizing technology, such as PatientTracking: AutoDischargeTM, if the DHC admission and departure process is not closely monitored, managed, and regularly reviewed. In fact, for facilities considering establishing a DHC for the first time (or initiating another effort after previous unsuccessful attempts), or seeking to further optimize operations of already existing discharge spaces or DHCs, integrated capacity management/RTLS technology can be expanded from managing cross-hospital operational patient flow and discharge to specifically surveilling DHC-related discharge operations, so the “last mile” of throughput and positive patient care impressions is completed successfully. Additionally, a capacity management technology-driven DHC can also serve as a critical patient overflow solution in the event of another public health crisis or disaster.
The DHC component of the overall discharge process has its own set of steps and intricate dynamics (which can also change in real-time) as the final leg of patient engagement and departure from a facility. If the patient Length of Stay (LoS) is reduced and engagement experience is optimized while in the DHC (including patient post-treatment education and ensuring understanding of discharge instructions), the DHC can also serve as a valuable tool for enhancing post-hospitalization at-home recovery and medication adherence as well as mitigating risks of readmission.
All the moving parts and participating stakeholders responsible for ensuring a DHC’s goals, milestones, and outcomes are successfully reached -- for both the patient and the hospital -- need all the help they can get to minimize errors in DHC and hospital team interactions, tasks, and process steps that can derail a DHC’s effectiveness. A structured, thought out plan for implementing a DHC, including all contingency scenarios for unforeseen circumstances at a per patient level and customized to a particular hospital or health system’s needs and culture, is a critical step; but keeping on top of and communicating the completion of each DHC-related action between care and logistics teams requires real-time visibility into those actions, including who, how, and when they are being performed, as well as how they impact newly-opened bed capacity patient placement opportunities.
The effectiveness of DHC team planning, collaboration, and execution activities can be best supported with an integrated capacity management/RTLS operational platform with mobile capabilities and data analysis tools that can cover areas that include:
There are a diverse range of hospitals and health systems that have had longer or more recent histories at attempting to stand up DHCs but are fully committed to their success, despite fits and starts along the way. Other facilities are still assessing whether they have all the needed criteria to make the move towards creating a DHC. Whatever category a healthcare facility finds themselves in, there is mounting evidence that automating the operations of these spaces with integrated capacity management and real-time location system applications are enabling a new level of breakthroughs in bed capacity and patient throughput efficiencies.
Examples of a diverse range of hospitals and health systems utilizing these technologies to run their DHCs include multi-facility systems stretching across the Midwest and South, a combined academic and community facility system serving multiple Northeast states, and an acute care trauma center treating patient populations in bordering New England regions. DHC operational outcomes have included:
Combined academic and community facility system serving multiple Northeast states:
Multi-facility system stretching across the Midwest and South:
Acute care trauma center treating patient populations in bordering New England regions: