The Discharge Brunch

The Discharge Brunch

How can you assure enough nurses per shift when your patients go home anytime between 9:00 AM and 9:00 PM? How can you be certain that all new mothers learn about post partum depression which is mandated teaching by state law? How do you send new families out the door well fed and feeling truly cherished? We addressed all these goals by implementing our “Discharge Brunch”. This innovative program is budget neutral and has received high praise from our patients, nurses and physicians. The challenges from concept to design to implementation will be addressed in this presentation. The authors are excited to discuss both problems overcome and huge successes. Staff nurses have been involved in each step of development. We even had a contest to name the program. A staff nurse coordinates and leads the brunch each morning. She visits each family scheduled for discharge that day, inviting them to the brunch.Background

We needed to solve several on-going problems: 1) How to empower patients to go home feeling confident to parent a newborn? 2) How to ensure that families leave our care feeling positive about their birthing experience? 3) How to encourage our patients’ timely, efficient discharge from the obstetrical unit? Before the Brunch was started, the discharge process took approximately thirty minutes of nursing time per family. Annually this equaled 0.4 full time equivalents (FTE) in salary cost. A demonstrated positive outcome of our Discharge Brunch was a 15% increase in the number of maternity patients who comfortably left the hospital by noon (a change from 48% in 2004 to 63% in 2006).

Process

The 0.4 FTE saved above has been dedicated to a Discharge Nurse who works four hours each morning. Meeting our goals required careful coordination with multiple hospital departments, and could not have been accomplished without the enthusiastic support of the Dietary Department. They purchased a beautiful cart for transporting and serving the Brunch, changing food and decorative themes with the seasons. The food costs were budget neutral. The brunch meal served to the support person was in lieu of the one previously provided immediately after birth. The mother’s meal cost was her inpatient lunch. Lessons Learned

· Be sure to communicate with all invested players: nurses, physicians, childbirth educators, security, housekeeping, etc.

· The invitation to attend the brunch needs to start the night before discharge or sooner!

· Lactation Consultants, Birth Registrars, etc. need to prioritize to see discharging patients first each day.Additional Benefits

• Patients have a clearer expectation of discharge time and procedure.
• There is decompression in the bottleneck between delivered patients tying up birthing rooms waiting for a bed on the mother/baby unit.
• Faster turnover of rooms by Housekeeping.
• Decreased overtime as staff gets undisturbed lunch breaks!

Happy chatter and sharing of birth stories rather than “rushed-and-harried-out-the-door”, our customers now leave for home feeling relaxed, refreshed, fed and cherished – a wonderful way to start out life with a new little family member!