Healthcare Informatics for Inpatient Discharge Scheduling

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INDUSTRIAL ENGINEER – APRIL 2015 VOLUME 47 : NUMBER 4

The patient discharge process in most hospitals is a loosely coordinated process that begins once an attending physician signs a discharge order. This process is traditionally fraught with uncertainty which leads to unpredictability in timing and delays I bad availability.

Would it be possible to redesign this process such that a patient may be provided with a fixed time on their day of discharge while simultaneously improving hospital efficiency?

A collaborative effort between academia and healthcare is detailed in the paper “Target Times for Inpatient Discharge Scheduling” by Timothy I. Matis and Jennifer A. Farris. They provide a mathematical program that integrates the preferences of patients, the realities of care providers and the availability of system level resources in generating target discharge times for each patient that collectively minimize the makespan, or the time between the start and finish of the discharge process on a given day. These times fall within patient on the day of discharge.

The supporting roles and responsibilities of caregivers and hospital staff in obtaining inputs to and utilizing outputs from this program are detailed, together with a description of a “discharge blitz,” a novel concept in which various caregivers come together with the patient to ensure discharge readiness. The guiding paradigm of relationship-based care is central to their design, and they comprehensively describe multiple facets of practical implementation ranging from technology to culture.