C3 Success: Enhancing Patient Flow with Estimated Date of Discharge

When a patient is admitted to the hospital for care, one of the most important pieces of information – for the patient, their loved ones and the healthcare system – is when they are expected to leave the hospital, often referred to as their Estimated Date of Discharge (EDD)—a key component for enhancing patient care. 

The Care Coordination Centre (C3) is Nova Scotia Health’s Command Centre and is a key resource improving patient flow across the province, streamlining the way patients move through the system and access resources and ultimately making care more efficient and effective. 

EDDs outline the expected timeline of the patient’s journey through the healthcare system, whether receiving care in one area, or requiring access to different levels of care. C3 plays a crucial role in facilitating this transition. Accurate EDDs help system planners bring together all the different components in the system (beds, staff, resources, etc.) for a better experience for the patient, their family, and the greater health system. 

This results in shorter lengths of stay, along with improved discharge planning and support. It also enhances bed management and resource allocation across the health system, reducing wait times for new patients.

EDD is initially based on standardized data from the Canadian Institute of Health Information (CIHI), but it is not a fixed metric. The CIHI data is a starting point, but it must be individualized and updated regularly according to the patient's specific circumstances. 

Any complications or changes in their condition would require an update to their EDD. 

The C3 technology uses data in near real time from current clinical applications for admission, discharge and transfers (e.g., STAR and Meditech). This replaced traditional methods of tracking discharges, typically whiteboards or paper. The new process allows EDDs to be displayed in a centralized digital system. As a key part of patient flow, regularly updating EDDs has improved visibility for all teams involved in access and flow, allowing for better planning and coordination of patient care throughout the healthcare system.

Alissa Decker sees the efficiency of C3 and EDDs firsthand as the director of Neurosciences, Orthopedics and Spine as well as in her role as clinical site lead for the Halifax Infirmary. She oversees four inpatient units that provide care in neurosurgery, neurology, stroke and orthopedics.

“C3 has become a critical tool for our teams. It helps us filter information efficiently and keeps everything organized. With the patient manager tile, we can track key details, making transitions smoother and communication clearer,” Decker noted. “Staff appreciate how it simplifies communication, especially during busy times, allowing them to quickly identify what needs to be done and keeping everyone on the same page.”

Decker emphasized the importance of EDDs, stating, “They are essential for managing patient flow effectively. They set clear endpoints for care, allowing our team to work backward to ensure all necessary steps are completed for a timely discharge. This proactive approach fosters better planning and communication among staff and with patients and their families, ultimately enhancing patient outcomes and operational efficiency.”

She further explained that the escalation feature in C3 has significantly improved communication processes between teams. “Instead of waiting for callbacks, staff can see in real-time where things stand, particularly regarding important referrals like MRIs and diagnostics.”

Involving patients in discussions about their EDD is another critical aspect of the process. This transparency helps patients feel more involved in their care journey and improving their overall care experience during their hospital stay. 

The integration of C3 and the focus on EDD has not only streamlined operations but also fostered a more connected and patient-centered approach to healthcare. C3 has significantly improved the efficiency of patient flow through the system, making it easier to manage and allocate resources effectively which translates to more effective use of hospital beds and better coordination among care teams.

Currently, 97 per cent of patients receive an EDD, marking a 60 per cent improvement from last year. To build on this success, teams are now focusing on enhancing EDD accuracy as patients approach discharge. 

Over the past year, EDD accuracy at discharge has risen by 15 per cent to 52 per cent, with ongoing improvements. The current target is to reach 70 per cent accuracy two days before discharge.

C3 teams continue to refine their processes to make patient care more efficient and effective across Nova Scotia’s healthcare system. This ongoing effort helps the system stay adaptable and responsive to the needs of patients and providers, creating a smoother and more effective healthcare experience throughout the province.

Note: The data presented in this profile may vary depending on the time the reporting is accessed.