As an R.N. case manager who has a small role with discharge planning, often times delays have to do with awaiting lab or other test results. The doses of medications that a patient will be discharged on are often determined by lab results for example the anticoagulant medication Coumadin is determined by the PT/INR result. Also getting x-ray and CT scan readings on day of discharge can cause major delays. Most hospitals now electronically transmit x-rays to radiologists all over the world and have to wait for a radiologist in Australia for example to read the films and transmit back the results. Some attending physicians will write discharge orders in advance but will include pending a particular lab or test result which requires the discharging physician/hospitalist to review the results and make any necessary order changes.
Believe me, the hospital staff dislikes these discharge delays as much as the patient because more often than not there is a patient in the ED who is in very much in need of that bed.
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