Sonam chophel
Nurses of NICU, JDWNRH, Bhutan
Title: Quality Improvement project on Discharge before 11am in NICU and Neonate ward, Jigme Dorji Wangchuck National Referral Hospital (JDWNRH)
Biography
Biography: Sonam chophel
Abstract
Introduction: Th ere are fi ft y key performance indicators in APA of JDWNRH to measure success of the organizational. Th e indicator 41, discharge of the patients before 11 am is one of them.
Objective: To increase the percentage of ‘before 11 am discharge’ from base line data of 38 % in (NICU) and 20% in (Neonate) to 50% in four months following interventions in in NICU and Neonate ward, JDWNRH
Method: Th e study was set in a 16-bedded NICU and 24-bedded Neonatal ward of National Referral Hospital in Bhutan. A Multidisciplinary Quality Improvement Team was formed. Baseline assessment included review of the daily activities and causes of delayed discharge were documented using root cause analysis. Th e data were collected daily and reviewed weekly. Th e interventions were developed based on the base line assessment and were implemented consistently. Th e change was monitored and reviewed periodically using the Plan Do Study Act (PDSA) method.
Result: Th e interventions included multiple system changes such as daily activity fl ow chart, new discharge checklist, screening checklist, high risk assessment checklist and due laboratory report fi le. Th e baseline percentage of patients discharged before 11 am before introduction of the interventions was 38.46% in NICU and 20% in Neonatal ward which drastically increased to 84.1% and 65.4% respectively following four months implementation of the interventions. Towards the end of 11th months, the percentage reached to 100% in NICU and 89% in neonate ward. In addition, it has improved teamwork, work effi ciency and brought in numbers of positive changes in the units.
Conclusion: A multidisciplinary team with quality improvement project improved this performance indicator and effi ciency of work but also teamwork.