Not every patient approved for discharge is able to vacate the hospital bed immediately. Some might be waiting on a prescription to be sent from the hospital pharmacy while others might have to wait for a family member to pick them up.

Keeping these patients in beds for non-care-related reasons can contribute to backlogs in the admitting process and increase the time sick patients sit in the emergency department (ED) until moving upstairs.

University Health System in San Antonio sought to address the issue by introducing a transitional care center on the first floor of its trauma tower, which opened in spring 2015. The approximately 2,500-square-foot enclosed waiting area serves those who’ve been discharged but aren’t able to immediately walk out the door, as well as direct-admit patients who come to the hospital and find there isn’t a bed available yet.

Says Marvina Williams, RN, senior medical planner and senior associate at Perkins+Will (Atlanta): “It’s a win-win situation. The approach we took led to operational efficiencies and cost savings for our client.”

To create a warm, non-clinical setting, the center is designed with a glazed glass wall entrance and residential furnishings, including recliners, artwork, TVs, a nourishment station, and private bathroom.

“They may have just come from a procedure or some may have fractured legs,” says Joyce Ornelas, RN director of the transitional care center at University Health. “We didn’t want them just sitting in your typical office waiting room chair.”

The unit, which is being relocated to a larger space on the third floor this year, is staffed by a licensed practical nurse and two technicians who can continue to monitor patients’ medical needs until they leave.

Medical gases are located on a wall in one area of the room for those needing oxygen, and a medication dispensing kiosk allows patients to send prescriptions directly to the pharmacy through a tube system and video conference with a pharmacist.

Ornelas says the transitional care center has improved operational efficiency at the hospital by reducing the amount of time patients remain in beds after they’ve been discharged. The hospital has set a goal to send 30 percent of all discharge patients through the unit this year.

Anne DiNardo is senior editor of Healthcare Design. She can be reached at