Avoid temporary solutions to patient flow

They create more problems than they solve

If your hospital moves discharged patients out of their room before they have transportation home or admits patients to the nursing station while they wait for a room, it’s time to rethink the idea, some experts say.

Discharge lounges, where discharged patients stay while waiting for a ride, were a popular throughput solution at one time, but one that experts discourage.

“When hospitals discharge patients to a lounge, they are setting themselves up for more issues,” says Tonya Kirby, BSN, MHA, MBA, senior director quality and safety collaborative for the Premier healthcare alliance.

For instance, patients may get up to go to the bathroom and fall. Even though they are discharged, they are still on hospital property.

“Discharge lounges didn’t work in the past, but some hospitals are trying it again. Discharge lounges are a risk for patients and a potential liability for the hospital,” says Brenda Keeling, RN, CPHQ, CPUR, president of Patient Response, Inc., a Durant, OK-based healthcare consulting firm.

Since the patients have been discharged and there are no orders, clinical services can no longer be provided, Keeling points out. Patients may decide to take the medications they are sent home with and take the wrong medications, she adds.

“It’s much better to educate the patient and family about the expected length of stay beginning with the day of admission and give them advanced notice about when their loved ones are going to be discharged,” Keeling says.

Instead of boarding patients in the emergency department, some hospitals are moving patients to the floor and admitting them to the desk. “This can create problems because if patients are sick enough to be in the hospital, they should be in a bed in a room, where they can get the treatment they need,” Kirby says.