Why discharge delays are still blamed on nursing staff despite having HIMS/PIMS ?

Why Nurses Get Blamed Despite HIMS/PIMS

The Core Reality:

HIMS/PIMS can show:

• ✅ Discharge order was placed at 10 AM
• ✅ Bills were generated at 11 AM
• ✅ Pharmacy order was sent at 10:15 AM

But HIMS/PIMS CANNOT show:

• ❌ Why patient is still in bed at 3 PM
• ❌ Which department is causing the delay
• ❌ What's actually blocking the discharge right now

What Actually Happens

Scenario 1: Patient Still Not Discharged at 3 PM

Hospital Management asks: "Why is the patient still here?"

Who gets blamed? → Ward Nurse/Nursing Superintendent

Why? Because:

• They're the "visible" person on the ward
• They're supposed to "coordinate" discharge
• HIMS shows discharge order was placed hours ago
• Management assumes nurse is "not following up"

The Reality:

• Pharmacy hasn't sent medicines (stock issue)
• Billing is waiting for insurance approval (TPA delay)
• Lab report pending (sample mix-up)
• Physiotherapy clearance not done (therapist was busy)

But nobody knows this because there's no real-time visibility.

Why HIMS Doesn't Solve This

HIMS is a Documentation System, Not a Coordination System

What HIMS does well:

• Records that discharge order was placed
• Generates bill
• Sends order to pharmacy
• Stores patient records

What HIMS does NOT do:

• Track whether pharmacy actually prepared the medicines
• Show if billing is stuck on insurance approval
• Alert nurse that lab report is ready
• Chase departments that are delaying
• Provide real-time status on "what's blocking discharge NOW"

The Blame Game - How It Plays Out

Example: Patient Discharge Delayed by 4 Hours

Hospital Administration POV: "HIMS shows discharge order was placed at 10 AM. It's now 2 PM. Why is patient still here? Nursing is not doing their job."

Nursing Staff Reality:

10:00 AM - Doctor places discharge order in HIMS
10:15 AM - Nurse calls pharmacy: "Send medicines for Room 304"
10:20 AM - Pharmacy: "We're preparing, will send soon"
11:00 AM - Nurse calls pharmacy again: "Where are the medicines?"
11:05 AM - Pharmacy: "Stock issue on one medicine, arranging from main store"
11:30 AM - Nurse calls billing: "Is bill ready?"
11:35 AM - Billing: "Waiting for TPA approval"
12:00 PM - Nurse follows up with pharmacy again
12:15 PM - Medicines finally arrive
12:20 PM - Nurse calls billing: "Bill ready now?"
12:30 PM - Billing: "Still waiting for TPA"
1:00 PM - Nurse escalates to nursing superintendent
1:15 PM - Superintendent calls billing head
1:30 PM - TPA approval comes through
1:45 PM - Bill printed
2:00 PM - Patient finally discharged

What HIMS shows: Discharge order 10 AM, Patient left 2 PM (4 hour )

Who gets blamed: Nursing ("Why did it take 4 hours?")

Who actually caused delay: Pharmacy (stock issue) + Billing (TPA approval)

But there's no data to prove this.

The Real Problem: Accountability Gap

Without Real-Time Tracking:

Nobody can answer:

• Which department caused the delay?
• How long did each step actually take?
• Who dropped the ball?
• Is this a one-time issue or pattern?

Result:

• Nurses blamed by default (they're the coordinators)
• Actual bottlenecks never fixed
• Same problems repeat every day

This is EXACTLY What ChatOps.health Solves

With ChatOps.health:

Timeline becomes visible:

10:00 AM - Discharge order placed
10:15 AM - Pharmacy task assigned: "Prepare medicines for Room 304" 11:45 AM - Pharmacy responds: "DONE - medicines sent" [Shows 1.5 hour delay in pharmacy]
10:20 AM - Billing task assigned: "Generate final bill"
1:30 PM - Billing responds: "DONE - bill ready" [Shows 3+ hour delay in billing - TPA approval]
2:00 PM - Patient discharged

Now you can see:

• Pharmacy took 1.5 hours
• Billing took 3+ hours (TPA approval bottleneck)
• Nursing is NOT the problem