| Sumario: | Significance & Background: Discharging oncology patients is a complex process involving multiple disciplines. Inefficiencies and lack of clear discharge ownership often result in delays, late discharges, extended hospital stays, and increased healthcare costs. These challenges prompted the development of a dedicated Patient Flow Nurse (PFN) role to streamline discharge coordination and improve patient throughput. Purpose: The PFN initiative aimed to enhance discharge efficiency by establishing clear ownership, proactively removing discharge barriers, and standardizing the discharge process. The primary goal was to discharge 40% of patients by noon by August 31, 2025, while decompressing the patient entry points and improving patient experience. Interventions: The PFN role was designed to begin discharge coordination three days prior to the expected discharge date (EDD), referred to as Day -3, Day -2, and Day -1, continuing through Day 0. During daily multidisciplinary rounds (MDR), the PFN led efforts to resolve discharge barriers, prioritize Day 0 discharges, and proactively prepare patients on Days -3 to -1. A structured escalation process was used when barriers remained unresolved. Results: The PFN initiative was piloted on a 48-bed leukemia unit and yielded significant improvements: discharges before noon increased from 26.6% to 66%, average discharge time improved from 14:48 to 12:52, and Press Ganey discharge information scores rose from 87.5% to 100%. Following the pilot, the initiative expanded to additional hematologic and cellular therapy units and was later adopted on the medical and surgical oncology units. Discussion: The PFN initiative demonstrated that nursing-led discharge coordination can significantly improve hospital throughput, reduce delays, and enhance patient experience. Its success supports broader implementation across complex care environments and highlights the value of proactive, structured discharge planning.
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