Improving Early Discharges With an Electronic Health Record Discharge Optimization Tool

Area of Science:

• Healthcare Informatics
• Quality Improvement
• Patient Flow Management

Background:

• Hospital discharge delays negatively affect patient care and resource availability.
• Limited research exists on using electronic health records (EHR) to expedite patient discharges.
• This study addresses the need for improved discharge timeliness in academic pediatric settings.

Purpose of the Study:

• To implement an EHR-based Discharge Optimization Tool (DOT).
• To increase the percentage of patients discharged before noon (DBN).
• To evaluate the tool's impact on discharge efficiency and patient outcomes.

Main Methods:

• A single-center quality improvement study involving pediatric hospital medicine teams.
• Implementation of a DOT integrated into the EHR workflow for communication.
• Primary outcome: monthly DBN percentage; Secondary outcomes: DOT utilization, accuracy, length of stay, and readmission rates.

Main Results:

• The DBN percentage significantly increased from 16.4% to 19.3% (P=0.0005).
• DOT utilization reached 87.2% with 75.6% accuracy in predicting discharge time (P<0.0001).
• Median length of stay decreased by 0.07 days (P=0.0033), with no adverse effect on readmissions.

Conclusions:

• An EHR-integrated DOT can be successfully implemented in academic settings.
• High utilization and accuracy of the DOT contributed to improved DBN rates.
• The tool facilitated better communication and workflow, enhancing discharge efficiency.