WIP 44 - Discharge huddles and checklists – a multidisciplinary QI approach towards timely newborn discharges in the post-partum unit.

Poster Number: WIP 44
Publication Number: WIP 44.2548

Background: At a high-turnover labor and delivery unit, it is imperative to provide timely discharges by noon to accommodate new patients and avoid the increased length of hospital stay due to system inefficiencies and non-medical issues, thereby decreasing hospitalization costs and improving staff and patient satisfaction. Currently, there are several non-medical barriers that frequently delay newborn hospital discharge. Identifying all elements required for discharge as early as possible, such as maternal laboratory results, maternal screenings for depression and domestic violence, completion of newborn screening, hearing testing, CCHD, discharge weight and vital signs, bilirubin levels, immunizations and prophylactic treatments, circumcision, social issues, teaching, transportation, and personal requests would help streamline the newborn discharge process.

Objective: To decrease the hospital discharge time from Newborn Nursery to noon, by coordinating care via a structured multidisciplinary checklist and morning discharge huddle.

Design/Methods: We developed a checklist of tasks to be completed before newborn hospital discharge. Pediatric residents completed the checklist and identified any missing information early in the morning. Deficiencies were communicated to nursing staff and social services during morning huddles. We used a “before and after” study design; prior to and after implementing the checklist over a period of 5 months, respectively. Newborns admitted to the post-partum unit were included in the study. Those babies born on weekends, under 48-hour observation for infectious conditions or on social hold were excluded from the study. We also excluded the first week of the residency block, given the steep learning curve for new interns in the Nursery. Data was entered on Excel and will be analyzed using SPSS 2.0.