Related Experiment Video
Updated: Jun 20, 2025
Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit
Published on: September 30, 2020
Driving in the Wrong Direction: Exploring the Unintended Consequences of an Early Discharge Program on Length of Stay
Paul Hodges1, Christopher A Linke, Johannah D Bjorgaard
1Author Affiliation: Quality & Safety Department, M Health Fairview, University of Minnesota Medical Center, Minneapolis, Minnesota.
Background And Objectives:
Early discharge of patients has become standard work in acute care settings to reduce inpatient length of stay (LOS), improve patient flow, and reduce boarding in the emergency department (ED).
Abstract:
Retrospective analysis of outcomes from a "discharge by 11 am " program at an academic medical center from January 1, 2020, to June 30, 2022. The analysis addresses the effects of a discharge by 11 am goal on time from discharge order release to patient discharge, ED boarding, LOS, and observed-to-expected LOS.
Methods:
Patient-level electronic health record data included discharge order entry time, discharge time, LOS, and diagnosis-related group geometric LOS (GMLOS). Additional unit-level data for ED boarding volumes and hours were included. Analyses were conducted at the hospital and unit levels where indicated.
Results:
Patients with a discharge order by 9 am have longer mean hours from order to discharge than patients without a discharge order by 9 am (9.04 vs 2.48 hours, P < .001) ED boarding total ( R2 = 46.2%, P ≤ .001), percentage ( R2 = 50.4%, P ≤ .001), median minutes ( R2 = 24.6%, P = .005), and total minutes ( R2 = 40.8%, P ≤ .001) all increased as discharge by 11 am performance improved. The mean LOS is longer for the discharge by 11 am group than the non-discharge by 11 am group -1.67; 95% CI, -2.03 to -1.28, P < .001). Discharge by 11 am patients had a LOS/GMLOS ratio 21.9% higher than the non-discharge by 11 am cohort (difference -0.31; 95% CI, -0.36 to -0.26, P < .001).
Conclusions:
Discharge order entry and release by 9 am and patient physically discharged by 11 am initiatives demonstrate a statistical increase in time from discharge order to discharge time, ED boarding, LOS, and observed-to-expected LOS.
More Related Videos
04:05Author Spotlight: Unveiling Prognostic Indicators in Heart Failure - The Role of Phase Angle and Bioelectrical Impedance Analysis
Published on: June 30, 2023
06:55Inverse Probability of Treatment Weighting Propensity Score using the Military Health System Data Repository and National Death Index
Published on: January 8, 2020
Related Concept Videos
01:31Discharge Summary Forms
Here's a detailed look at the key components and guidelines for preparing a discharge summary:
01:21Planning Nursing Care I
01:22Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
01:19Restorative Care
00:59Hospitals-II
Nurses that work in...
01:29Appendicitis-II: Diagnostic Studies and Management
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...