Hospital discharges often take a long time, and may even extend your hospital stay to another day. Often you’re ready to go, but something is hung up. The best analogy is the similar problem around airplane turnaround time, that is the time from landing to being able to push back for the next flight.
Not only are there many parallel processes ongoing at the same time (deplaning and unloading of luggage), but many steps depend on the previous step to be complete (cleaning the aircraft can only happen after most passengers deplane). You can have the fastest cleaning crew, but that’s of no use if the new pilots are still on their way from another airport. A domino effect can also be in play where a delay in one process creates even more delays elsewhere: imagine a situation where there is only one ground crew team. A delay in one plane landing means it will arrive at the exact same time as another plane.
It is the same for your hospital discharge. There are often many parallel and sequential events that need to take place for your discharge to go through:
- Advanced imaging needs to be taken, interpreted, and acted on
- Take home medication needs to be planned, made, and given with instructions to the patient.
- Lab tests need to result
- Patient condition needs to be stable
- Additional consultations need to be made, such as dietician, social work, other specialists.
- Outpatient appointments need to be made
- Medical transportation needs to be arranged.
There is no simple solution, especially as a patient. The best way is to communicate with your primary nurse and physician. Ask these questions:
- What are the necessary things that need to be done before I can be discharged?
- What is the bottleneck to completing these things? In other words, what is often the hold up given these list of things that need to be done? For instance, scheduling MRI and CT scans often contribute to discharge delays because availability is limited. Am I waiting for a medication that can instead be picked up at an outside pharmacy?
- Are there any safe alternatives that we can consider? Often your discharge is being delayed for a good reason. You as the patient need to be confident about your health at home, things to look out for, and what you need to do if something changes.
