Medically Fit for Discharge Audit

This project audits whether patients who no longer meet Criteria to Reside are identified, documented and actively progressed towards safe discharge. It reviews Criteria to Reside review and documentation, Discharge Ready Date, discharge pathway, the reason for ongoing stay and delay category, whether discharge actions have a clear owner and timescale, escalation where barriers persist, and medicines, therapy, equipment, social care, transport, communication, capacity, safeguarding and handover elements needed for safe transfer.

• Ward teams, acute medicine, frailty and specialty inpatient teams
• Discharge coordinators, care transfer hub, site and patient flow teams
• Nursing, pharmacy, physiotherapy and occupational therapy teams
• QI leads, governance teams, operational managers, supervisors and educators

• Measure whether Criteria to Reside review and Discharge Ready Date are documented
• Identify discharge barriers, delay categories and unresolved actions
• Assess ownership, timescales and escalation of discharge actions
• Quantify variation between clinical areas and pathways to target improvement
• Generate governance-ready and ARCP-ready evidence and a re-audit cycle

• Anonymous case identifier
• Inclusion / eligibility decision
• Anonymised context (age band, sex/gender recorded, care setting, assessment context)
• Clinical area / location and optional specialty / service
• Twenty discharge-readiness criteria (met / not met / not applicable)
• Free-text learning points and any project custom fields

• Live dashboard
• Audit report (Word)
• Executive summary (Word)
• Excel workbook
• PowerPoint presentation
• Conference poster
• ARCP evidence summary

This ready-built project is developed using the guidance, standards and authoritative sources listed below, so you can see what is being measured and why. Lazomis QI does not publish or own this guidance, and inclusion here does not imply endorsement or approval by any of these organisations.

• Department of Health and Social Care / NHS England

  Hospital discharge and community support guidance (including Criteria to Reside and discharge pathways)(opens the original source in a new tab)

  National guidance on discharge planning, Criteria to Reside and discharge pathways 0–3. Confirm the version locally adopted.

• NHS England

  Discharge Ready Date guidance and frequently asked questions(opens the original source in a new tab)

  Defines Discharge Ready Date recording and reporting. Confirm local recording practice and EPR fields before setting targets.

• NHS England

  Reducing long hospital stays and improving discharge flow(opens the original source in a new tab)

  Suggested source requiring user review — confirm which long-stay, stranded-patient or discharge improvement resources are locally used.

• NHS England / GIRFT / Society for Acute Medicine

  Model acute pathway / board round and ward round standards(opens the original source in a new tab)

  Suggested source requiring user review — confirm which flow and board round standards the project has locally adopted.

• Local policy

  Local Criteria to Reside, Discharge Ready Date, discharge planning and care transfer hub policies

  Local policy defines Criteria to Reside review frequency, Discharge Ready Date recording, pathway definitions, delay categories, escalation routes and criteria-led discharge. Confirm local policy before setting targets.

• Legislation / local policy

  Local safeguarding and Mental Capacity Act / best-interests policy(opens the original source in a new tab)

  Statutory framework where capacity, best-interests or safeguarding processes affect discharge planning.

• Designed to use anonymised or pseudonymised audit identifiers.
• This tool supports, but does not replace, clinical judgement.
• Local policy, formulary and specialist advice should be followed.
• Organisations remain responsible for local governance arrangements.
• This tool supports, but does not replace, clinical judgement. Follow local Criteria to Reside, discharge planning, capacity, safeguarding and escalation policy.
• Delay categories, discharge pathway definitions, escalation rules and timing thresholds are locally configurable and are not presented here as national standards. Nothing in this tool implies discharge should occur where it is unsafe or unsupported.
• Use anonymous case identifiers only — never patient-identifiable information.

Supporting guidance from the Lazomis QI Resource Library. Authoritative clinical standards referenced by this project remain separate.

• Patient FlowImproving Board Round Effectiveness for Enhanced Patient FlowThis article outlines practical strategies for NHS teams to enhance the effectiveness of board rounds, fostering better patient flow, streamlined decision-making, and improved multidisciplinary team communication. It provides actionable advice for clinical leads and operational managers looking to optimise this critical daily meeting.
• Patient FlowOptimising Patient Flow Through Effective Board RoundsEffective board rounds are a cornerstone of efficient patient flow within NHS hospitals, facilitating coordinated care and reducing bottlenecks. This guide explores their strategic implementation and common challenges.
• Quality ImprovementPlanning Effective PDSA Cycles for Quality ImprovementThis guide provides a practical, step-by-step approach to planning effective Plan-Do-Study-Act (PDSA) cycles for quality improvement initiatives within the NHS, focusing on robust design and learning. It covers essential considerations from defining your aim to anticipating challenges, helping teams systematically test changes.
• Patient FlowOptimising Hospital Flow: The Critical Role of Effective Board RoundsEffective board rounds are a cornerstone of efficient hospital operations, playing a crucial role in coordinating patient care, managing risks, and optimising patient flow. This resource explores the key elements that contribute to a successful board round and provides practical guidance for their implementation.