www.ijcmr.com International Journal of Contemporary Medical Research ISSN (Online): 2393-915X; (Print): 2454-7379 | ICV: 77.83 | Volume 5 | Issue 8 | August 2018 H1 Section: Hospital Administration Study of Hospital Discharge Process viz a viz Prescribed NABH Standards Shahnawaz Hamid 1 , Farooq A Jan 2 , Haroon Rashid 3 , Susan Jalali 4 ORIGINAL RESEARCH ABSTRACT Introduction: NABH defines discharge as a process by which a patient is shifted out from the hospital with all concerned medical summaries ensuring stability. The discharge process is deemed to have started when the consultant formally approves discharge and ends with the patient leaving the clinical unit. The study aimed to view the discharge process of SKIMS, compare it with NABH criteria AAC 13 and 14 and look for any bottlenecks. Material and Methods: The study was carried out in General medicine and General Surgery wards of inpatient department of SKIMS. It was an observational type of study where in all the patients who got discharged in the said wards from 10am to 4pm daily (Except Sundays) were observed for Discharge process including average time taken and the existing Discharge Process in SKIMS was compared with National board of Hospitals and health care organization (NABH) standards and objective elements. Results: A total of 710 Discharged patients were observed during the study period which includes 417 patients from General surgery department and 293 patients from General medicine side. The results show that the average time taken for discharge process was 240 minutes for those who had a planned discharge and had to pay out of pocket (Self- Payment). It was 255 minutes for those who had been discharged against medical advice (DAMA) while it was 270 minutes for below poverty line (BPL) patients who had to exempt hospital charges. The discharge time for all types of discharges was higher when compared to NABH criteria’s. Conclusion: The results clearly indicate that average time taken for all types of discharges in SKIMS is more than prescribed NABH criteria. SKIMS as per the observations is following many objective elements of standards AAC 13 and 14 but discharge process and time needs to be defined and documented. The SKIMS should formulate a policy regarding a discharge process of a hospital wherein steps and time taken should be clearly defined and all measures should be taken in order to adhere to NABH standards. Keywords: Discharge Process, NABH, AAC INTRODUCTION Hospital discharge process is defined as, “the process of activities that involves the patient and the team of individuals from various discipline working together to facilitate the transfer of patient from one environment to another” 1 As per NABH, “Discharge is a process by which a patient is shifted out from the hospital with all concerned medical summaries ensuring stability. The discharge process is deemed to have started when the consultant formally approves discharge and ends with the patient leaving the clinical unit 2 Hospital discharge process is one of the very lengthy procedures. Discharge time taken by hospitals is an important indicator of quality of care and patient satisfaction. The patient as well as his relatives are eager to resume their routine life immediately and any undue delay in the discharge process leads to patient dissatisfaction and takes a toll on image of the hospital, even after a successful and satisfactory treatment. Delay in Discharge of the patient also increases the pressure on beds of the hospital and is bad for both hospitals and the patients. It increases cost to the hospitals and is depressing to the patients. Delayed discharge also increases the patient’s exposure to hospital acquired infections. 3 So, effective strategies must be in place to solve this issue. National Accreditation Board for Hospitals and Health Care Organizations (NABH) has set a standard of 180 minutes for the completion of the discharge process. Hence, maintaining an acceptable level of discharge time provides competitive edge to the organization. 4-6 Researchers suggest that appropriate discharge processes enable the list of available beds for admission to be kept current and accurate, and ‘in addition, we can obtain useful data by accurate registration of patients in the admission book …’ and calculating there from the admission and discharge dates for each patient. Complications in the discharge process and unnecessary routines causes discharge delay and patient dissatisfaction. The discharge process represents the final contact between the patient and the hospital health professionals, and the outcome of all procedures undergone by the patient are recorded at this stage. The study aimed to view the discharge process of SKIMS, compare it with NABH criteria AAC 13 and 14 and look for any bottlenecks. MATERIAL AND METHODS It was an observational type of study undertaken on patients discharged from the General Medicine and General Surgery Wards of of Sheri-Kashmir institute of medical sciences (SKIMS), Srinagar a 783 bedded tertiary care hospital 1 Senior Resident, Hospital Administration, 2 Professor, Hospital Administration, 3 Associate Professor, Hospital Administration, 4 Resident Medical Officer, SKIMS Corresponding author: Dr. Shahnawaz Hamid, Near Professor Colony, Kanitar, Naseemabad, Sadrabal, Srinagar, 190006 How to cite this article: Shahnawaz Hamid, Farooq A Jan, Haroon Rashid, Susan Jalali. Study of hospital discharge process viz a viz prescribed NABH standards. International Journal of Contemporary Medical Research 2018;5(8):H1-H4. DOI: http://dx.doi.org/10.21276/ijcmr.2018.5.8.29