Early availability of laboratory results increases same day ward discharge rates

Michael P. Cornes 1 , Graham Danks 2 , Sanna Elgaddal 3 , Mohammed Jawad 4 , Jayne Tonks 3 , Elisabeth Ries 5 , Clare Ford 2 ,  and Rousseau Gama 2 , 6
  • 1 Department of Clinical Biochemistry, Worcestershire Acute Hospitals NHS Trust, Worcestershire, Ireland
  • 2 Department of Blood Sciences, The Royal Wolverhampton NHS Trust, Wolverhampton, Ireland
  • 3 Surgical Wards, The Royal Wolverhampton NHS Trust, Wolverhampton, Ireland
  • 4 Public Health Policy Evaluation Unit, Imperial College London, Hammersmith, London, Ireland
  • 5 Information Department, The Royal Wolverhampton NHS Trust, Wolverhampton, Ireland
  • 6 Research Institute, Healthcare Sciences, Wolverhampton University, Wolverhampton, West Midlands, Ireland
Michael P. Cornes
  • Corresponding author
  • Department of Clinical Biochemistry, Worcestershire Acute Hospitals NHS Trust, Worcestershire, Ireland
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, Graham Danks
  • Department of Blood Sciences, The Royal Wolverhampton NHS Trust, Wolverhampton, Ireland
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, Sanna Elgaddal, Mohammed Jawad
  • Public Health Policy Evaluation Unit, Imperial College London, Hammersmith, London, Ireland
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, Jayne Tonks, Elisabeth Ries, Clare Ford
  • Department of Blood Sciences, The Royal Wolverhampton NHS Trust, Wolverhampton, Ireland
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and Rousseau Gama
  • Department of Blood Sciences, The Royal Wolverhampton NHS Trust, Wolverhampton, Ireland
  • Research Institute, Healthcare Sciences, Wolverhampton University, Wolverhampton, West Midlands, Ireland
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  • degruyter.comGoogle Scholar

Abstract

Background:

Delayed discharge reduces hospital efficiency and inconveniences patients. Most hospitals discharge in the afternoon, whereas the most common admission time is mid-morning. Consequently, new patients wait for the beds of patients who are fit to be discharged. Earlier discharge may, therefore, improve patient flow. We investigated the impact of early phlebotomy with early availability of laboratory results on patient discharge rates and discharge time.

Methods:

Discharge rates, discharge time and sample turnaround time were assessed before (1 October 2014 to 31 December 2014) and after (1 October 2015 to 31 December 2015) introduction of earlier phlebotomy with availability of laboratory results prior to the ward rounds on two surgical wards.

Results:

Following the intervention, over 95% of results were available before 8:30 am in 2015 as compared to less than 1% in 2014. Specimen turnaround times were similar in both study periods. Even after adjustment for age, gender, admission type and length of admission, the same day discharge rate was higher in 2015 compared to 2014 (60% vs. 52%; p<0.002), but time of discharge was unchanged.

Conclusions:

Early availability of blood results prior to ward rounds increased ward discharges but did not affect discharge time.

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Clinical Chemistry and Laboratory Medicine ( CCLM) publishes articles on novel teaching and training methods applicable to laboratory medicine. CCLM welcomes contributions on the progress in fundamental and applied research and cutting-edge clinical laboratory medicine. It is one of the leading journals in the field, with an impact factor of over three. CCLM is the official journal of nine national clinical societies and associated with EFLM.

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