Does your hospital have a cutoff time for discharges?

[NextGen]

My hospital has discharged patients to home as late as 11:00 pm. This includes patients who have a 1 hour drive to get home. At a friend's hospital, they have discharged to home as late as midnight. These are not situations where the patient is stating that they are ok with a late discharge.

Does your hospital have a policy stating the cutoff time for discharges?

Thanks for your input.

[SouthernPoint]

The hospital I worked for discharged 24 hrs a day. Didn't matter if a patient was completely set up for home health (if ordered) or not. I remember driving a patient home once because they had no one to pick them up and couldn't afford a taxi.

I get hospital's are a business, but there should be a cut off of 6pm. That is unless something has been prearranged.

[Meriwhen, ASN, BSN, MSN, RN]

Technically we could discharge someone at any time. We usually cut it off by 8pm.

[elkpark]

I've never worked anywhere where there was an official cut-off time for discharges. Everyone did their best to arrange for discharges to take place at reasonable hours, but people are discharged home when they're ready to go. Often, it's v. late because that's when transportation could be arranged. Would people rather be charged for an additional day at the hospital simply because they'd prefer to be discharged the next morning? Their insurance company certainly won't be okay with that.

Sometimes discharges at awkward times take place because family members have been balking at providing transportation home for the individual or clients have been reluctant to participate in discharge planning. I work in a large, regional referral hospital, and we get people transferred to us from, sometimes, several hours' drive away. I was involved in a case recently in which the individual was ready for discharge, all of the outpatient follow-up services and appointments had been scheduled, etc., and the family came up with various excuses all day about why no one could come pick up this individual (I'm talking about obviously flimsy excuses). The case manager finally, late in the afternoon, had to explain in plain English that this person was being discharged today, and the options were for someone from the family to come pick the individual up, or for us to send the individual home in a wheelchair van -- the wheelchair van company had quoted a price of $1800 for the trip (it was a long drive and this individual lived 'wayyyy out in the country), and, oh, by the way, that isn't covered by insurance so you (the individual and family) will be responsible for that bill out of pocket. The family member on the telephone quickly reported that someone would be coming to pick the person up (although it was going to be late in the evening before they could get there).

[xoemmylouox, ASN, RN]

I don't know of any around here that have a cut off time, but I do know they try to d/c at a reasonable time. It mainly depends on when we can get all of the d/c orders in and signed off on. Then you are waiting on the patient's transportation.

[Meriwhen, ASN, BSN, MSN, RN]

xoemmylouox said:

I don't know of any around here that have a cut off time, but I do know they try to d/c at a reasonable time. It mainly depends on when we can get all of the d/c orders in and signed off on. Then you are waiting on the patient's transportation.

That's usually why we try to cut it off by 8pm: because the patient has to get home somehow, and not every patient of mine has a ride that will come to get them.

Though if someone really wanted out at 11:30pm, we wouldn't stop them. We'd strongly advise against it and would encourage them to wait until the morning...but if after all that they still want to go, we let them go.

[~PedsRN~, BSN, RN]

Our "goal" is to have people out by noon. We are pretty good at this, if we can wrangle the docs to round in time. :) But no, we do not have a "MUST BE OUT OF HERE BY" time - we discharge at pretty much all hours. But I will say, most of the time a late discharge is per a family request. I have never discharged someone in the middle of the night because a doctor deemed them ready to go home. Usually the discussion is.... they can go home tonite if they want, or we can send them home first thing in the morning.

Families with small kids often opt for the morning option. :)

[KelRN215, BSN, RN]

When I worked in the hospital, I discharged patients as early as 4-5am and as late as 12-1am. The last time I was in the hospital, I was discharged at 10pm.

[whichone'spink, BSN, RN]

Typically, only during day shift. The latest I've seen someone go is close to 1900, just before change of shift. Our goal time to discharge patients by is 1100, and we're supposed to tell patients that. I have actually discharged patients before 1100.