Goals-to-Discharge Patient Checklist: Implementing a Program to Optimize Recovery After Surgery for Patients With Colorectal Cancer.
Nicole Trocchia Mattessich
PMID 32441689WHAT IT FOUND
After a bedside discharge checklist, average discharge time did not change (2 hours and 24 minutes vs 2 hours and 25 minutes), but average hospital stay was shorter (2.66 vs 3.13 days) and more patients left before noon (40% vs 10%).
Key findings
01Average discharge time did not differ: 2 hours and 24 minutes after implementation versus 2 hours and 25 minutes before implementation.
02Mean length of stay was 2.66 days after implementation versus 3.13 days before implementation, a statistically significant change.
0340% of patients left before noon after implementation, compared with 10% before implementation.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Small English-speaking convenience sample from one colorectal unit, so results may not apply to other patients or settings. Before-and-after quality improvement design without randomisation or blinding. Other discharge initiatives and new ERAS order sets were changing on the unit during the period. Preimplementation data did not include individualized discharge times, so only average discharge time could be compared. Length of stay analysis excluded four postimplementation patients and 12 preimplementation open procedures, so the groups were not fully comparable.
The easy way to misread this
Do not read the shorter stay and earlier before-noon discharges as proof the checklist alone worked. The study was a before-and-after pilot, patients were on an ERAS pathway, and other discharge initiatives and new order sets were also changing on the unit.