Hospital Case Study
Understanding Acute Coronary Syndrome Discharges in a Hospital Setting
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Context:
Public hospitals are under immense pressure to offer efficient treatment and swift discharges. The hospital in question is a large facility in Melbourne, managing numerous emergency hospitalizations annually. During 2016-2017, there were significant admissions for Acute Coronary Syndrome (ACS).
Objective:
The goal was to understand the discharge processes and how to meet patient needs while extending hospital care routines systematically to home care. The focus was on understanding the typical experiences of patients who are discharged unsuccessfully and distinguishing between patients who are readmitted and those who are not.
Approach:
The team, consisting of members from the University of Melbourne and digital health academics, used a three-stage approach: reviewing medical records, interviewing patients at key points in their hospital journey, and conducting a process mining project to match patients' experiences with their digital medical records.
Findings:
The analysis revealed that the process was highly complex, with a broad range of factors contributing to patients returning to the hospital post-discharge. One crucial observation was that patients who were not readmitted received a nursing assessment for discharge, focusing on individual patient needs and stressors.
Implications:
The findings were verified through focus groups with nursing staff, leading to process improvement suggestions. The information obtained can support both ground staff and higher-level strategic decision-making, clarifying how a process is operating for all parties involved.
Next Steps:
The subsequent steps involve the routinization of the person-centered approach at the hospital, balancing the demands of operational efficiency and person-centered care approach towards discharge, considering that readmission incurs its own human and financial costs.