Ambulatory Care Nightingales: COVID Response Discharge Unit

Background: During the COVID-19 epidemic, UW Health Northern Illinois, SwedishAmerican, saw a rise in hospitalizations. The organization mobilized an ambulatory care nurse-led discharge unit to improve bed capacity management. This innovative solution was able to serve over 200 patients. This unit exemplified transformative leadership and innovation during the height of the pandemic.

Purpose: The purpose of this unit was to provide respite to the inpatient units by creatively improving bed capacity at the organization. The goal was to use resources available to promote patient care and keep surgical procedures ongoing.

Methods: In November 2020, the discharge unit called 1 North was developed. The unit had an experienced team with over 100 years of ambulatory care experience including manager, supervisor, educator, nurses, and ancillary support. Ambulatory care staff volunteered to be trained and work for an 8-week period. The unit was open Monday through Friday from 7am to 7pm and located in a converted conference room. Admission criteria was developed with the goal to discharge patients to keep surgical volumes and inpatient bed capacity stable. Daily leadership evaluated surgical volumes along with inpatient census to collaborate, prioritize, and determine the best plan to meet the organizations needs. Post-implementation, a response plan has been developed if the unit is needed in the future.

Findings: Over 200 patients were seen in the discharge unit during the 8-week implementation. This unit improved hospital revenue by $320,000 from surgical procedures that were able to continue. The nursing staff felt empowered and appreciative to offer support to the inpatient staff while providing strategic collaboration. Overall this innovative response was a breath of fresh air and was an exemplar during our Magnet designation in 2021.