A Comparative Analysis of Process Mapping and Standardised High-line Flow Process in Hospitals to Develop SOPs for Discharge: A Research Protocol

Introduction: Efficient patient discharge is a critical component of hospital workflow that directly influences bed availability, patient satisfaction, and healthcare costs. However, delays in discharge remain a persistent challenge across hospitals, particularly in resource-constrained settings like the Wardha district. These delays are often the result of administrative inefficiencies, inadequate coordination among healthcare providers, and poor communication. Need of the study: With the National Accreditation Board for Hospitals (NABH) recommending that discharge be completed within 180 minutes, delays beyond this threshold indicate systemic inefficiencies. There is a pressing need to identify the underlying causes of these delays and to develop evidencebasedStandard Operating Procedures (SOPs) that can streamline the discharge process and improve hospital performance. Aim: To compare the efficacy of a process mapping plan of action versus a standardised high-line process strategy in reducing discharge Turnaround Time (TAT) and to develop validated SOPs that enhance discharge efficiency. Materials and Methods: A Randomised Controlled Trial (RCT) will be conducted at Acharya Vinobha Bhave Rural Hospital in Wardha, Maharashtra, India, from June 2025 to October 2025. Healthcare staff will be randomly allocated to either the experimental group (process mapping) or the control group (high-line process). Both quantitative and qualitative data will be collected on discharge TAT, workflow efficiency, and reasons for delay. A Chi-square test for categorical variables and a paired t-test will be used for time series data to evaluate the impact of both strategies. A p-value of <0.05 will be considered statistically significant.