Objective: The proportion of discharge records completed before 1:30 PM at the General Surgery Department of Children's Hospital 2 was only 66%. This study was conducted to identify the causes and apply quality improvement interventions to increase this proportion.
Subjects and Methods: A pre - post intervention quality improvement study was conducted on 986 discharge records in the General Surgery Department of Children’s Hospital 2 between February and September 2025. Of these, 243 records were assessed during the pre-intervention phase, while 743 records were included in the intervention phase. Four key interventions were implemented across three consecutive Plan - Do - Study - Act (PDSA) cycles: early surgical schedule review meetings, earlier approval scheduling by department leaders, the use of an administrative discharge checklist, and proactive verification and completion of health insurance documentation within the first 48 hours of hospitalization. The intervention phase included 247 records in Cycle 1, 264 in Cycle 2, and 232 in Cycle 3.
Results: A pre-intervention survey of 243 discharge records showed that 66% were completed before 1:30 PM. After three intervention cycles, this rate improved significantly: 77% in cycle 1, 95% in cycle 2, and 79% in cycle 3. Overall, the average rate for all 743 cases after the intervention was 84%. Delayed discharges were mainly due to objective factors such as delayed health insurance supplementation, software errors, or subjective factors such as delayed discharge examinations.
Conclusions: The interventions improved the proportion of discharge records completed before 1:30 PM from 66% to 84%. These findings suggest that the implemented measures were feasible and may contribute to improving the efficiency of the discharge process. Ongoing monitoring and process refinement will be important to sustain these improvements following the implementation of the new discharge software.