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/ Designing Discharge after Emergency Care (D.DEC)
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/ Collaborators: Dr Kate Sellen (OCAD University), Dr Sam Vaillancourt, Dr Sahil Gupta (St. Michael’s Hospital, Unity Health)
/ Contributors: Yesmeen Ghader, Matthew Beaubien, Alessandra Ceccacci, Galo Ginocchio, Christopher Rice, Victoria Weng. |
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/ Overview
Keyword: Emergency care, co-design, designing discharge, discharge information
Discharging information after emergency department (ED) care enhances patients' self-care, understanding of health concerns, and next steps. At St. Michael’s, most patients receive verbal communication only, despite efforts to include written materials. Using co-design with patients, ED staff, and family physicians, we developed a Patient-Oriented Chart (POC) for use at discharge. The POC, intended to be integrated into the physician ED chart, is printed for every registered patient. It provides personalized information, digital access guidance, and coordinated discharge details, improving communication among ED staff and follow-up with primary care providers. / Background & Need Prior research with patients who had recently received care in the emergency department (ED) identified four meaningful outcomes: Symptom relief, Understanding, Reassurance, and Having a plan. These outcomes form the basis of PROM-ED, a patient-reported outcome measure for use with patients discharged after ED care. PROM-ED supports measurement of the impact of care improvements on these outcomes. PROM-ED was applied to improving the discharge process as a critical component of ED care. There are many challenges with discharge communication, including language and literacy levels, diversity of patient population, variability in physician communication according to routines and time availability. This leads to barriers to continuity of care for patient’s follow-up at home and with other providers such as family physicians. Need: Design a better discharge communication process that is scalable for patients and their care team beyond the ED. |
Process
Unity Health at St. Michael’s Hospital and OCAD University partnered for the Designing discharge after emergency care (D.DEC) initiative that brought together different people affected by this issue to find creative solutions that can be sustained in the ED’s fast-paced care setting. This is a collaboration with emergency physicians, emergency nurses, family physicians, and patients and family partners, to reimagine and co-design a new discharge communication tool. Service and co-design methods were applied to this challenge. The process consisted of 1) Literature Review, 2) Field Observations & Interviews, 3) Journey Mapping & Service Prototyping (4 co-design sessions with 57 patient scenarios), and 4) Field Testing and Feedback. 
/ Outcome
Prototype communication tool for ED discharge that is easy to implement and scale and available for further development and testing.
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