Targeted interventions to improve discharge times in a cardiology department: a quality improvement project in Australia

Late discharges in cardiology inpatient units contribute to patient flow inefficiencies and poor patient outcomes. The authors conducted an interventional quality improvement study in an Australian cardiology inpatient unit over the course of 1 year, aiming to reduce the frequency of late discharges, defined as those that occur after 12:00 pm. Baseline mean discharge times were calculated over 1 month to identify causes of delays, then new departmental policies were created and implemented to improve discharge times, using the plan-do-check-act framework. Discharge outcomes were reassessed at 1 and 6 months post intervention. Key reasons for delayed discharge included delayed ward rounds and paperwork, or the requirement of review from another faculty. Interventions included formalising ward round commencement times, optimising discharge planning and enabling junior staff to more readily enact discharges. At 1 month post intervention, there was a significant reduction in the median discharge time of 87 minutes (95% CI 11–134 minutes, P <0.01). This was sustained at 6 months, with an 80-minute reduction compared to baseline (95% CI 23–130 minutes, P <0.01). This indicates that targeted interventions can improve discharge efficiency in cardiology inpatient units, enhancing patient flow and operational performance. This framework could potentially inform similar initiatives in other settings.