Discharge procedures

Earlier today, I had gone to help out a relative who had been admitted to hospital, and who was getting discharged today. The procedure was bizarre, to say the least.

A little before noon, a nurse walked into the room announcing that the discharge formalities were being put in place, and asked us if we had insurance cover (we didn’t). She reappeared five minutes later in order to remove the thing through which the intravenous drip and medicines had been administered. We thought it was time for us to leave, and informed people at the relative’s home to get lunch ready. What we didn’t know was that the “release” process would take nearly three more hours.

Every few minutes, I would walk up to the nurse station on the floor, and ask them when the discharge would happen. For the first one hour, they would tell that the bill would be ready “in ten minutes”. Finally I lost patience (my loss of patience doesn’t exactly make me an appropriate choice of personnel to manage discharge, I know) and asked them to direct me to the person who was actually preparing the bill. The bill was ready a minute after I appeared in front of that person, and it had been settled in the next five minutes.

A word here about the billing procedures. The relative’s ward was on the fifth floor, and I went down to the basement (“floor minus two”) to the billing section where I got the bill. I had to then take the bill and walk up to the ground floor to the cash section to make the payment, and once again take the receipt back down to the basement to get a printed bill.

Anyway, I thought most of the ordeal was done and proudly announced to the nurses at the nurse station that the bill had been cleared and they should let us go. But the discharge summary remained, and for the next hour or more, they said it would be ready “in the next ten minutes”. And once it was done, a nurse had to run down to the basement (yet again!) to collect it and get the signature of the doctor on duty. And run back up six floors (in another bizarre policy, hospital staff are forbidden from using the elevators!).

Then there was the set of prescriptions that were delivered to us regarding the medicines we had to buy for the following one week (and I’ll write a separate post on drugstores located within hospital premises). This wasn’t the first time I was helping someone get discharged, and this wasn’t the first time the discharge process took this long. From my own anecdotal experience, and from that of other relatives who I was talking to today, this is more the norm than the exception.

This makes me wonder why most hospitals, without fail, have such screwed up discharge procedures? Is this a matter of such low priority that all hospitals can consistently choose to ignore it? It is not like the amount of work that needs to be done is immense, so I wonder what prevents hospitals from streamlining the procedure? Or, like some hotels do, fix a discharge time so that they can batch process the procedures?

The problem, in general, with people in businesses that makes them feel noble, I tell you, is that they are not willing to heed to advice. And are not willing to question themselves enough. The nobility of their profession, they believe, places them too high to deal with mundane trivialities such as time taken to discharge a patient! And I’ll write a separate post soon on people in noble professions.