The optimal time for patient discharge is when they are medically safe to go home, when the ongoing medical care needs can be equally well provided at home, and when the parents are confident in their abilities to provide this care.

Avoiding unnecessary delays in patient discharge has many benefits to the child and family:

• parents and children get back to their familiar home environment
• the family dislocation and disruption associated with hospitalisation is less
• the risk of nosocomial infection is reduced (there is strong evidence that the risk of hospital acquired infection is proportional to length of hospital stay)

There are also other benefits:

• beds are made available for other patients
• there is less cancellation of elective admissions
• there is less prolonged waiting for beds for patients being admitted from the Emergency Dept

Criteria-led Discharge is one method that has been shown to reduce unnecessarily prolonged hospital stay. It has been used for some years in several areas of the hospital and is now being introduced to all areas. For appropriate patients, Criteria-led Discharge means the nursing staff can discharge a patient once certain medical criteria have been met (for example not requiring supplemental oxygen for at least 12 hours in certain respiratory conditions). We are in the process of designing forms with diagnoses-specific criteria for common conditions, and there will also be a more generic form which can be used for other patients. Patients can be selected as appropriate for Criteria-led Discharge through discussion between medical and nursing staff.