Reducing discharge delays: using DMAIC approach in a tertiary care hospital

Background: Efficient hospital discharge processes are crucial for enhancing patient satisfaction, ensuring bed availability, and reducing healthcare costs. However, the complexity of discharge procedures often leads to delays that frustrate patients and hinder overall hospital efficiency. This study aimed to improve discharge time in a tertiary care hospital by applying the define, measure, analyze, improve, and control (DMAIC) technique. Methods: A cross-sectional study was conducted on 1000 patients discharged from a tertiary care hospital in north India. Data was collected using a researcher-developed questionnaire validated through a pilot study. The DMAIC approach was applied to analyze the discharge process, identify bottlenecks, and implement targeted interventions. Pre- and post-intervention discharge times were compared to assess the effectiveness of the improvements. Results: Pre-intervention analysis revealed significant delays in receiving discharge summaries (235.29±78.36 minutes) and obtaining clearances under various healthcare financing schemes, particularly Ayushman Bharat (436.46±451.30 minutes). Post-intervention, the average time to receive discharge summaries reduced to 72.55±42.46 minutes, and Ayushman clearances improved to 162.65±95.162 minutes. The total discharge time decreased from a mean of 329.16±389.31 minutes to 208.11±122.87 minutes. Patient satisfaction with the discharge process increased, with 88.8% rating their experience as either “excellent” or “good” post-intervention. Conclusions: The application of the DMAIC technique led to significant improvements in hospital discharge time and patient satisfaction. The study demonstrated the effectiveness of systematic process improvement approaches in healthcare settings. Continuous monitoring and improvement efforts are necessary to sustain and further enhance these gains.