QI Story: Quality Improvement in Discharge Process at AIC Kijabe Hospital


By Tabitha Mwangi & Finance Manager AIC Kijabe Hospital

The project aims to enhance the customer experience by reducing the Turnaround Time (TAT) during discharge from the hospital. Customer interviews revealed dissatisfaction with long waiting queues, extended TAT at discharge, patient confusion, and delays lasting over 4 hours for clearance and gate pass issuance.

In response, various steps were taken to improve the discharge process. These included implementing surgery calls a day before discharge notification, enhancing discharge summary review, notifying nurses, and improving IT infrastructure for efficient data handling. The discharge summary process was optimized with IT support and improved Wi-Fi networks. Medication accountability was improved by involving nurses in the drug sign-in process.

Steps were taken to address discrepancies in billing, educate staff, and explore case management for private patients. Billing for corporate patients was streamlined, staffing challenges were addressed, and biometric machines were utilized. Security assistance was enhanced, billing advisors were notified, and the discharge process for private patients was streamlined. Plans were made to introduce biometric machines to eliminate the need for a separate window for NHIF services.

The gate pass issuance process was optimized, and the pharmacy pickup process was streamlined. The final sign-off process was simplified. Collaboration with the discharge team, clinicians, and relevant stakeholders led to the consolidation and centralization of discharge services. Necessary equipment was acquired, staff training was conducted, and all stakeholders were sensitized on their roles.

The project emphasized the importance of moving forward, leading to the closure of the old billing office. Post-project customer surveys indicated significant improvements in discharge processing times, with positive feedback on hospital services and staff competence. The hospital is now recognized as the “Hospital of Choice,” with recommendations and positive feedback from patients regarding fast and efficient discharge processes.

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