Investing in a New Role to Increase Timely Morning Discharges in the Inpatient Setting

Area of Science:

• Healthcare Management
• Quality Improvement
• Patient Flow Optimization

Background:

• Hospital discharge delays negatively impact emergency department capacity, wait times, and elective admissions.
• Efficient patient flow is crucial for hospital operational efficiency and patient care.

Purpose of the Study:

• To increase the percentage of hospital discharges before noon from a hospital medicine service.
• To sustain this increase over a 6-month period.

Main Methods:

• Implemented a dedicated patient flow provider (PFP), workflow optimization, technology assistance, and multidisciplinary education.
• Primary outcome: percentage of discharges before noon. Secondary outcome: length of stay (LOS).
• Analyzed equity and regression, with 7-day readmissions as a balancing measure.

Main Results:

• Discharges before noon increased from 19% to 34%.
• On PFP days, discharges before noon were 43% vs. 22% on non-PFP days.
• Length of stay remained stable; no change in 7-day readmissions. Persistent disparities noted for minority and non-English speaking patients.

Conclusions:

• A dedicated staff member for discharge tasks significantly improved early discharges.
• Further studies are needed to assess the financial impact and address persistent disparities in early discharges for specific patient groups.