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Related Concept Videos

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Discharge Summary Forms

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The discharge summary is crucial as it enables a smooth transition from a healthcare facility to a patient's home or another care setting. This critical document facilitates seamless continuity of care, ensuring patients receive the necessary support and attention.
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Multipipe systems consist of complex configurations of interconnected pipes designed to transport fluids efficiently across intricate networks. They are essential in engineering applications requiring precise control over flow distribution, pressure, and head loss. They are categorized into series, parallel, loop, and network configurations, each distinguished by unique flow characteristics and applications.
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Related Experiment Video

Updated: Jun 28, 2025

Continuous Instream Monitoring of Nutrients and Sediment in Agricultural Watersheds
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Increasing and sustaining discharges by noon - a multi-year process improvement project.

Ryan Bailey1, Ankur Segon2, Sean Garcia2

  • 1The University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr, San Antonio, TX, 78229, USA. baileyr1@livemail.uthscsa.edu.

BMC Health Services Research
|April 17, 2024
PubMed
Summary
This summary is machine-generated.

Increasing early hospital discharges by noon improves emergency department (ED) performance and patient outcomes. This process improvement project successfully boosted early discharges without negatively impacting key patient safety metrics.

Keywords:
Emergency department boardingHospital capacityHospitalistLength of stayMultidisciplinaryPatient dischargePatient readmissionPatient safetyProcess improvement

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Area of Science:

  • Healthcare Management
  • Process Improvement
  • Hospital Operations

Background:

  • High hospital occupancy negatively impacts emergency department (ED) performance, leading to increased wait times and adverse patient outcomes.
  • Late patient discharges are a significant contributor to prolonged hospital occupancy and ED overcrowding.
  • Optimizing discharge timing is crucial for enhancing hospital efficiency and patient care.

Purpose of the Study:

  • To describe a process improvement initiative aimed at increasing and sustaining early hospital discharges at a large academic medical center.
  • To evaluate the impact of interventions on the proportion of early discharges and key hospital performance metrics.
  • To provide a scalable roadmap for other academic facilities seeking to improve discharge timeliness.

Main Methods:

  • Implementation of iterative Plan-Do-Study-Act (PDSA) cycles over 41 months, following the Institute of Medicine Model for Improvement.
  • Introduction of multiple, evolving interventions designed to facilitate earlier patient discharges.
  • Continuous monitoring of performance metrics, including discharge timing, Risk-Adjusted Length of Stay (RA-LOS), mortality, and readmissions.

Main Results:

  • The proportion of discharge orders before 10 am significantly increased from 8.7% to 22.2% (p < 0.001).
  • The proportion of discharges by noon (DBN) rose substantially from 9.5% to 26.8% (p < 0.001).
  • Key balancing metrics showed no negative impact; RA-LOS decreased (1.16 to 1.09, p=0.01), and RA-Readmissions decreased (0.92 to 0.74, p < 0.001).

Conclusions:

  • Sustained increases in early discharges are achievable in large academic medical centers through systematic process improvement.
  • The implemented strategies enhanced hospital efficiency without compromising patient safety or increasing readmissions.
  • Multidisciplinary engagement, adaptability, and institutional support are vital for successful implementation and sustainability.