Project Discharge: Implementing an Effective, Patient-Centered Discharge Process in Obstetrical Triage in an Urban Academic Medical Center

Background: An effective, patient-centered discharge process is the standard of care for any patient discharged from a hospital unit, including obstetrical triage units. Local Problem: University of New Mexico Hospital’s obstetrical triage unit had no standardized discharge process for pregnant and postpartum women presenting for care. The aim of this quality improvement project was to discharge 65% of patients from OB Triage over an eight-week period using an effective, patient-centered discharge process by harnessing team and patient engagement and a discharge checklist and summary. Methods: A quality improvement model involving four rapid-cycle plan-do-study-act (PDSA) cycles was utilized. Tests of change were implemented and the outcomes of these interventions were determined by analyzing data plotted on run charts. Interventions: Primary interventions were a multi-faceted team engagement plan, a patient decision aid, discharge checklist, and discharge summary. Results: Over the eight-week project, 668 of 800 (83.5%) women were discharged from OB Triage using an effective, patient-centered discharge process. Team members shared the decision aid with 48% of patients, and patients reported a median confidence score of 92% in their ability to decide when to access OB Triage. Team self-confidence rose from 51% at baseline to 84% at project conclusion. Conclusions: Team motivation and communication play vital roles in an effective discharge process that consequently has a positive impact on patient knowledge of self-care. Discharge summary was incorporated into the electronic health record