Discharge delay-A pitfall for NHS; Can we improve?

Abstract Aim Identify reasons for discharge delays from hospital and areas of improvement and any scope for trainees to make a difference – Trainee lead intervention. Method All inpatients including Elective and Emergency admissions were included from all 3 teams over 1 week. Data were collected on Microsoft Excel and analysis done with SPSS. Result Total 102 patients were included (Purple 44, Yellow 40, Red 18). Mean age was 60.5 years. 54 (52.9%) patients were Female. 57.4% data were missed for clinical frailty score (CSF). 46.5%patients had polypharmacy. 61 patients did not have any Expected date of Discharge (EDD). Mean Length of Hospital stay (LOS) is 18.01 days and median 10 (1–161) days. Total 27 patients were delayed. 1 stayed for 161 days awaiting rehab bed. Mean Duration of delay was 4.93 days and Median 1 day (1–42).4 patients were waiting beds outside of hospital for 3, 6,10, >30 days;6 patients were delayed for Stoma nurse review for average 1 day. Delayed discharges do not seem to be affected by polypharmacy (p=0.067), DNACPR (p=0.926), frailty score (p=0.761) or gender (p=0.518), or which team they were on (p=0.801). Discharges are however affected by age(p=0.037). Conclusions Our recommendations were to Identify patient at risk of discharge delay by trainees on admission by CSF, early identification of care requirements with OT/PT, regular EDD review, pre-emptive discharge letter preparation. We also recommended increased resources like training of senior nurses to assess stoma training, phlebotomists/ new clinical support worker to collect early morning bloods, increased Surgical bed capacity.