title: Discharge planning in a cardiology out-patient clinic: a clinical audit.
abstract: OBJECTIVE
  The purpose of this paper is to audit the active discharge (DC) planning process in a general cardiology clinic, by pre-assessing patients' medical notes and highlighting those suitable for potential DC to the clinic physician.
  
  
  METHODS
  The cardiology clinical nurse specialist (CNS) identified patients' for nine- to 12-month return visits one week prior to attendance. The previous consultation letter was accessed and information was documented by the CNS in the medical record. The key performance indicator (KPI) used was patient DCs for each clinic visit. The process was audited at three separate times to reflect recommended action carried out.
  
  
  RESULTS
  The CNS pre-assessment and presence at the clinics significantly increased total DCs during the first period compared to usual care, 11 vs 34 per cent (p < 0.0001). During the third audit period, DCs fell (9 per cent) with a reduction in CNS pre-assessed DCs (10 per cent). Recommendations were implemented. The process was continued by clinic administration staff, colour coding all nine- to 12-month returns, resulted in a 19 per cent DC rate in 2012.
  
  
  CONCLUSIONS
  CNS pre-assessment and highlighting DC suitability increased the number of patient DCs. As the CNS presence at the clinic reduced so did the rate of DC. Specific personnel need to be responsible for monitoring and reminding staff of the process; this does not always have to be medical or nursing.
  
  
  CONCLUSIONS
  Implementing positive discharging procedures is aimed at improving quality, increasing efficiency and accessibility of services for patients. This audit describes a process to promote DC planning from cardiology outpatients.
authors.forename: Shirley
authors.initials: S
authors.lastname: Ingram
authors.forename: Barkat
authors.initials: B
authors.lastname: Khan
mesh_terms: D000554:Ambulatory Care Facilities / Q000458:organization & administration* / Q000706:statistics & numerical data; D002309:Cardiology / Q000458:organization & administration* / Q000706:statistics & numerical data; D054869:Clinical Audit / Q000706:statistics & numerical data*; D017598:Efficiency, Organizational; D006801:Humans; D009720:Nurse Clinicians / Q000458:organization & administration*; D010351:Patient Discharge / Q000706:statistics & numerical data*; D011785:Quality Assurance, Health Care; D019984:Quality Indicators, Health Care