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How much do operational processes affect hospital inpatient discharge rates?
Hannah Wong1, Robert C Wu, George Tomlinson
1Department of Mechanical and Industrial Engineering, University of Toronto, Toronto, ON, Canada.
Journal of Public Health (Oxford, England)
|May 26, 2009
Summary
Patient discharge rates significantly vary by day of the week and holidays. Team scheduling and organization also impact daily discharge volumes, suggesting process improvements can optimize patient flow.
Area of Science:
- Healthcare Management
- Hospital Operations
- Medical Informatics
Background:
- Daily patient discharge rates exhibit significant variability.
- Factors influencing discharge timing include operational and scheduling elements.
Purpose of the Study:
- To analyze the impact of day of the week, holidays, and team scheduling on daily patient discharge rates.
- To identify key predictors of daily discharge volume variation.
Main Methods:
- Retrospective analysis of 5088 patients from the General Internal Medicine (GIM) inpatient service (2005-2006).
- Statistical evaluation of factors including day of week, holidays, on-call status, and attending physician coverage.
Main Results:
- Weekend discharges were over 50% lower; Friday discharges were 24% higher.
- Holiday Mondays had 65% lower discharge rates, with increased pre-holiday discharges.
- On-call teams had 15% higher discharge rates; post-call teams had 20% lower rates.
Conclusions:
- Day of the week, holidays, and team organization significantly predict daily discharge rate variations.
- Optimizing discharge rates may involve enhancing weekend/holiday capacity and reorganizing admitting/attending schedules.
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