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Faced with high occupancy levels, Howard University Hospital, Washington, has opened a discharge lounge, where patients ready to go home can relax until their rides show up.

"We were having late discharges, patients waiting for their families to pick them up, and it was tying up the beds we desperately needed for new admissions," says Mayble Craig, RN, MSN, interim chief nurse officer at Howard. "It frees up the bed."

The lounge provides an easily accessible room where discharged patients can comfortably pass the time in recliners. Housekeeping can clean their former rooms and prepare for other patients awaiting admission. Outpatient surgery patients discharged from the PACU also wait in the lounge. A transport aide based in the lounge picks up patients from the units or surgical area.

"Patients are monitored and given a meal while waiting," says Crisilda Liburt-Simmons, RN, BSN, nurse coordinator of the discharge lounge at Howard. Liburt-Simmons is a former nurse manager nearing retirement.

Less independent patients requiring treatments or frequent monitoring, such as those being transferred to an institution providing a lower level of care, remain in their hospital beds. Liburt-Simmons can administer medications, but in the 10 months since the lounge opened, that need has not occurred. The lounge, just inside the front door, is open from 11 AM to 7:30 PM and has room for 13 patients. A social worker assists with transportation planning for those patients without rides.

Nutrition services provides a box lunch to patients with a prolonged wait. Some of the patients watch TV. Others chat with each other while waiting for their rides to arrive.

"They like to talk and socialize with the nurse," Liburt-Simmons says. "I am there to give support – physically, mentally, socially."

Liburt-Simmons reinforces education provided by nurses on the floor. Each patient arrives with a discharge instruction sheet, so she knows the basics of what the patient needs to know. But sometimes she will call up to the floor to ensure she teaches the same things. Outpatients awaiting transportation, family members, or community service buses have discovered the lounge, too.

Craig acknowledges implementation of a discharge lounge within a hospital is not an original concept. The University of Michigan Health System established one more than 25 years ago to address the need to optimize inpatient bed turnover in years of consistent 100% census. Craig is, however, pleasantly surprised by the improved patient flow and positive feedback from patients.

"Patients are very supportive and appreciative of this service," Liburt-Simmons says. "They are in a safe environment, and the care is continuous. Even though they are discharged from the floor, they know we are there giving them the support they need until they go home."

Debra Anscombe Wood, RN, is a freelance writer.

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