Standardized Documentation of Fast Track Discharge by Medical Team

Introduction:

A fast track discharge is considered when someone has a life-limiting illness, and their condition appears to be rapidly deteriorating.

The Fast Track Pathway aims to provide patients with access to NHS continuing Healthcare as quickly as possible with minimum delay.

Given the nature of the needs, this time period should not usually exceed 48 hours from receipt of the completed Fast Track Pathway Tool. ICBs should ensure that they have commissioned sufficient capacity in the care system to ensure that delays in the delivery of care packages are minimal.

If this discharge is delayed then it causes frustration for the patient, family and it longer the stay in the hospital. Hence why, we decided to conduct a QI project to find out the causes for this delay and how to tackle them.

Methodology

The data was collected from the patient’s notes who were admitted under the Geriatric department, and it was a retrospective study.

1st cycle: November 2023 to January 2024, and collected 150 patient  details

2nd cycle: February 2025 to March 2025, and collected 38 patient details.

Results

Among 183 discharges, only 57 discharges happened within the 48 hr time period, equaling 31%. 69% were delayed.

35% of delayed discharges were due to poor documentation by the medical team, and the remaining 34% were due to other reasons.

After completion of first cycle, we introduced a template for a proper documentation by the medical team. In second cycle, the ratio of discharges within 48 hour was 79% which was a significant improvement.

Conclusion

Delay in fast track discharge is a big concern, leading to an unwanted long stay in the hospital.

A proper documentation which fulfils the ICB’s requirements can lead to a discharge on time, which will be cost-effective for NHS too.