Transit Lounges

Aim

Improving patient flow by ensuring the patient receives safe and appropriate nursing care in the right environment, at the same time enabling inpatient beds to be ready and waiting for acutely ill patients.

Benefits

Transit lounges is beneficial when:

• access block from ED to wards
• large numbers of patients waiting in acute beds for discharge
• large volume of patient throughput

Background

Transit Lounges or Transit Care Hubs were developed to accommodate patients waiting for an appointment, admission or discharge, to ensure patients receive safe and appropriate care in the right environment, while enabling inpatient beds to be available for acutely ill patents.

Evaluation and results

An overall formal evaluation of Transit/Discharge Lounges has not been undertaken, however local sites may have evaluated locally, particularly with respect to reducing length of stay or time in emergency department.

Lessons learnt

Transit lounge for effective discharge

• Facilitates the timely discharge of patients who were previously waiting in an acute bed for discharge medications, discharge summaries, transport, test results etc.
• Frees up the bed in the ward for the next patient, thus alleviating access block in the ED
• Patients who are otherwise well are not treated as sick in the ward
• Reduced hospital average length of stay
• Can also manage the avoidable admissions of patients by being the link between the hospital and options for care in the community. Eg. Hospital in the home, hospital in the nursing home, community services

Transit lounge for outpatients / day surgery patients

• Allows patients to enter the hospital system at an earlier time if travelling from a rural/remote area or has been transported by an ambulance
• Pre-appointment work up can be done at the transit lounge
• Patient is not occupying an acute bed unnecessarily

Transit lounge for admission / transfer from other hospitals

• Alleviates ED access block by providing an alternative entry point for patient transfers from other hospitals
• Less anxiety for the patient being in the ED
• Less workload for the already busy ED staff
• More appropriate use of ED beds

Further Reading

Emergency Medicine Journal Article: Effectiveness of a multipurpose observation unit: before and after study

The Royal Melbourne Hospital: What is the Transit Lounge?