Essential components for implementing care coordination and discharge procedures
Abstract
Children’s Mercy Hospital (CMH), a 390-bed free-standing paediatric hospital in Kansas City, Missouri, implemented a formalised patient progression programme in 2022 to enhance patient throughput from pre-arrival to discharge. Utilising Lean process improvement methodologies, CMH identified 88 projects aimed at improving patient progression. In May 2023, CMH opened a patient progression hub, centralising key teams and integrating advanced technology to monitor and manage patient flow. A significant emphasis was placed on discharge and care coordination, with the mission of ensuring safe and timely discharges. Important initiatives included hiring a discharge expediter (DE) to address discharge barriers and implementing projected discharge date (PDD) and clinical readiness date (CRD) to improve discharge transparency and preparation. The patient progression hub features technology from GE Healthcare, with 16 screens continuously displaying pertinent throughput information such as organisational capacity, emergency department (ED) capacity, planned and confirmed discharges, and patients needing transfer from the intensive care unit (ICU) to the medical/surgical units. This real-time data sharing has been crucial in coordinating care and expediting discharges to address system bottlenecks. Additionally, CMH introduced ‘lightning rounds’, which are quick multidisciplinary huddles to review discharge needs. Afternoon rounds were implemented to facilitate continuous communication between charge nurses and care managers. These efforts, supported by innovative technology, have led to substantial improvements in patient outcomes. Timely, well-coordinated discharges have reduced hospital stay durations, minimised readmission rates and enhanced overall patient satisfaction. The initiatives have also resulted in improved capacity management, allowing CMH to better serve its patient population and ensure high-quality, patient-centred care.
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Author's Biography
Ashley Daly , MD, FAAP, currently serves as the Medical Director of the Patient Progression Hub at Children‘s Mercy Hospital (CMH). She is a paediatric hospital medicine physician with over 22 years of medical practice experience. She served as an associate professor of paediatrics at the University of Missouri-Kansas City School of Medicine and a clinical assistant professor of paediatrics at the University of Kansas School of Medicine.
Sherry McCool , MHA RRT-NPS, CMTE, currently serves as the Senior Director of Patient Progression at Children’s Mercy Hospital (CMH). She led the development of the Patient Progression Hub and oversees the Patient Progression Department, Critical Care Transport, Transfer Center, Internal Transport, Staffing Office, Float Pool and MedSurg Overflow Areas.
Bethany Bolt , MHA, BS, CHES, joined CMH in 2023 and is currently serving as the Business Analyst within the Patient Progression Hub. She is responsible for data analysis, business management and strategic planning to support patient progression. Bethany has a master’s in health administration from the University of Missouri and a bachelor of science from Tuman State University. She is also a certified health education specialist (CHES).
Jodie Winfrey , RN, BSN, BA, CPN, joined CMH in 2000 and is currently serving as the discharge expeditor within the Patient Progression Hub. She is responsible for leading changes to break down system barriers to patient progression, throughput and discharge, enabling improved capacity so that the right care can be provided at the right time to the patients that need our care. Jodie has a bachelor’s degree in nursing from Baker University, a bachelor’s degree in early childhood development from the University of Kansas and is certified in paediatric nursing.
Citation
Daly, Ashley, McCool, Sherry, Bolt, Bethany and Winfrey, Jodie (2025, February 13). Essential components for implementing care coordination and discharge procedures. In the Management in Healthcare: A Peer-Reviewed Journal, Volume 9, Issue 3. https://doi.org/10.69554/NSDM6033.
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