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A Multidisciplinary Initiative to Increase Inpatient Discharges Before Noon
Marlena Kane1, Ann Weinacker, Rudolph Arthofer
1Author Affiliations: Executive Director (Ms Kane), Performance Excellence & Medicine Services; Administrative Director (Mr Arthofer), Hospital Operations Center, Administration; Administrative Director (Mr Seay-Morrison), Clinical Support Services, Patient Care Services; Visualization Developer (Mr Elfman), Clinical and Business Analytics; Project Manager (Mr Ramirez), Performance Excellence; Director of Research (Dr Pickham), Patient Care Services; and Chief Operations Officer (Mr Hereford), Administration, Stanford Health Care, Menlo Park; and Vice Chair of Medicine (Dr Weinacker), Quality Implementation, Department of Medicine; Clinical Associate Professor (Dr Ahuja), Medicine; and Professor and Chief (Dr Welton), Colon & Rectal Surgery, Stanford University School of Medicine, California.
Objective:
The aim of this study is to evaluate the effect of 2 hospital-wide interventions on achieving a discharge-before-noon rate of 40%.
Background:
A multidisciplinary team led by administrative and physician leadership developed a plan to diminish capacity constraints by minimizing late afternoon hospital discharges using 2 patient flow management techniques.
Methods:
The study was a preintervention/postintervention retrospective analysis observing all inpatients discharged across 19 inpatient units in a 484-bed, academic teaching hospital measuring calendar month discharge-before-noon percentage, patient satisfaction, and readmission rates. Patient satisfaction and readmission rates were used as baseline metrics.
Results:
The discharge-before-noon percentage increased from 14% in the 11-month preintervention period to an average of 24% over the 11-month postintervention period, whereas patient satisfaction scores and readmission rates remained stable.
Conclusions:
Implementation of the 2 interventions successfully increased the percentage of discharges before noon yet did not achieve the goal of 40%. Patient satisfaction and readmission rates were not negatively impacted by the program.
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