Patient Carol Hicks (with charge nurse Becca Humphreys above) was ready to be discharged after spending a week on 300 East, but she knew she would be at Cox South a little longer that Wednesday afternoon. It was 3 p.m. and her son would be picking her up, but not until his workday ended at 5. Hicks had been a 20-year CoxHealth employee before her recent retirement, so she says she was especially aware of the need for beds on nursing floors.
“The worst thing is knowing that there is a patient waiting for your room, but there’s nowhere for you to go,” she says. Hicks’ situation is a common one for patients at Cox South, common enough that leaders are addressing it with an innovative solution known as the Discharge Hospitality Center. Within a few minutes of her discharge, Hicks was relaxing in a recliner in a private room in the new center. She had a sandwich and drink from the Atrium Café and a comfortable place to rest while she waited for her ride.
“It makes me feel better to be here and I know making the bed available made the next person who needed care up on the floor feel better, too,” she says.
Since it began as a pilot last November, the Discharge Hospitality Center has offered discharged patients a private place to wait and it has helped improve throughput by freeing up beds on patient care units.
“Nobody likes to wait, especially when they’re sick,” says Sonya Hiller, director of Ambulatory Services. “The first question patients ask is ‘When can I go home?’ This gets them one step closer and it helps free up beds so other patients’ stays can be shortened.”
The center came about as a result of a lean team project examining patient flow from the surgical ICU to 300 East. The lean team identified waiting for a ride home as one of the bottlenecks in patient flow. Between people’s work schedules, private Medicaid transport and patients whose families are from outlying areas, there are plenty of patients who are unable to leave upon discharge. The team began looking for a comfortable place for patients to await their rides; they found their solution in a unit that is typically full in the morning, but has space available by afternoon, when many patients are being discharged from nursing floors.
Same Day Surgery’s Unit B is now home to the Discharge Hospitality Center. The creation of the center is a good example of a way to readjust resources we already have to make the biggest difference possible for our patients’ comfort and for ongoing issues such as access and throughput.
“The square footage is there the whole time; this just makes the best use of it for our patients,” says charge nurse Becca Humphreys, who does dual duty on the unit. Attached to her lapel, Humphreys wears a double-sided nametag: on the front, she’s in Same Day Surgery, on the back, she’s in the Discharge Hospitality Center. The nametag mirrors the structure of the center itself: in the mornings, the rooms are dedicated to patients getting ready for surgery. As patients move into the operating room, rooms become available for patients who are being discharged upstairs. The center is open 9 a.m.-7:30 p.m. weekdays. By 9 a.m., two rooms are typically available and by afternoon, the Discharge Hospitality Center can house up to 12 patients.
The center offers patients not just a place to stay, but also a variety of services to make the experience as comfortable as possible. Alongside the comforts of recliners, snacks and coffee, Humphreys works directly with discharged patients to review discharge information and answer any questions they may have.
Humphreys talked with Hicks about her prescriptions, her diet and how to control her blood sugar. Hicks was also able to get her prescriptions filled by Convenient Care Pharmacy, whose staff delivered them to the hospitality center.
“Some things I’ll need tonight and they brought those to me – that’s really good,” Hicks says. “Even though I feel good, I didn’t feel like making a stop at the pharmacy.”
Connie Deck, administrative director of nursing, says that in developing the Discharge Hospitality Center, leaders chose to focus on reinforcing an excellent patient experience, with features like the partnership with Convenient Care.
In addition to the clinical support and reviewing discharge instructions, Humphreys also provides patients a dose of personal attention. Hicks told her about her grandkids and family, and Humphreys even helped Hicks submit a Partners nomination for one of the aides on 300.
“Becca has been wonderful – you’ve definitely got the right person down here,” Hicks says.
Humphreys says she enjoys visiting with patients and making sure their stay ends on a positive note. “We want to meet all of their needs,” she says. “Safety is number 1, but their comfort is right after that.”
When she’s not staffing the center, Humphreys also acts as the liaison for the facility’s services, meeting with nurses and patients on the floors and introducing herself. She attends huddles and helps staff members identify patients who would be good candidates for the hospitality center. She has also created a set of streamlined instructions for nurses on the floors who may have patients they want to transfer.
“Nurses are busy; we want to help them out with straightforward forms to make it easy and make things work for our patients,” Humphreys says.
In addition to providing a place for guests to await their rides, the Discharge Hospitality Center also allows discharged patients a comfortable place to wait for the delivery of medical equipment they may need after their stay. Chris Davis, of CoxHealth Home Support, delivers a portable oxygen tank to patient John Bohe of Nixa as Bohe was preparing to return home. Davis reviewed the tank’s setup and helped Bohe try out the device for the first time.
Nurses on patient care floors appreciate the effort. On 300, nurse manager Dana Essary says staff members are taking advantage of the center and they’re seeing the ways it can make a difference for their patients.
“This is a real benefit for people coming into the hospital,” Essary says. As beds are freed up, new patients are able to move onto the unit more quickly. Staff members communicate with families to let them know their family member will be discharged to the center. They can then call a transporter as usual, fill out a quick SBAR (situation, background, assessment, recommendation) and send patients to the center.
Deck says nurses can sometimes be reluctant to let go of patients, not wanting to feel like they’re “handing off” a patient rather than sending them home. She says it’s important for staff to remember that patients at the center are discharged and that reinforcement of instructions for patients or their families can be delivered by Humphreys, who is only a phone call away.
“Nurses are passionate and protective and they want to get everything done for their patient,” Deck says. “We want nurses to be comfortable with using the center; it’s just another way we serve our patients.”
The Discharge Hospitality Center accepts patients who meet certain criteria, including needing minimal assistance and having a wait that is expected to be longer than 30 minutes.
Humphreys and center leaders are working on ways to expand the criteria so more discharged patients can use the rooms. The center will also be available to accommodate sleep lab patients who come in at 5 p.m. before the lab opens at 7:15 and leaders are working to assist with outpatient oncology patients.
In addition to providing a comfortable waiting area for discharged patients, the center also offers a prime location for families to pick up their family members. Rather than walking into the front lobby and then going up to a floor, they now have easy access to the West Pavillion entrance.
With those advantages and efforts to promote the facility, leaders expect usage of the center to grow. Essary says that’s encouraging, since the center ties directly into so many parts of CoxHealth’s overall strategic plan.
“You have to look at the big picture: Bringing more patients in and making the best use of the space helps our throughput,” she says. “That, in turn, helps patient satisfaction and it helps the organization financially. We want to provide the best for employees and this helps us do that.”
Hicks says that from a patient’s perspective, it’s the right thing to do. As a long-term employee who worked in Medical Records and Occupational Medicine at Cox North, Hicks says the addition of the Discharge Hospitality Center makes her proud.
“CoxHealth is very important to me and a service like this is a big plus,” she says. “This is a bigger benefit than a lot of things that might look bigger. When I see something like this that makes patients comfortable, I know Cox is on the right track."