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Discharge before noon: Effect on throughput and sustainability.

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Area of Science:

  • Healthcare Operations
  • Hospital Management
  • Patient Flow Optimization

Background:

  • Late afternoon hospital discharges contribute to admission bottlenecks.
  • An intervention successfully increased the discharge before noon (DBN) rate on two inpatient medicine units.

Purpose of the Study:

  • To evaluate the effect of an increased DBN rate on admission arrival times and hourly admission numbers.
  • To assess the sustainability of the DBN initiative.

Main Methods:

  • Retrospective analysis of pre-/postintervention data from two acute-care inpatient medicine units.
  • Data included patient arrival and discharge times from June 2011 to December 2014.
  • A multidisciplinary intervention aimed to increase the DBN rate.

Main Results:

  • A statistically significant shift in median admission arrival time from 5 PM to 4 PM.
  • Significant reduction in high-frequency admission peaks for emergency department (ED) admissions.
  • Sustained statistically significant increase in the DBN rate, reaching 35%.

Conclusions:

  • Increasing the DBN rate correlates with earlier patient arrivals and reduced admission peaks.
  • The improvements in DBN rates achieved through the intervention are sustainable.
  • Optimizing discharge timing can positively impact hospital admission flow.