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Reducing hospital admission delay times using a structured, systematic, multi-disciplinary approach.

Nathan Baskin^1,2, Kavon Javaherian^1,2, Josue Zapata^1,2

¹Department of Medicine, University of California, San Francisco, San Francisco, California, USA.

Journal of Hospital Medicine

|April 16, 2025

Summary

Hospital admission delays were reduced by implementing standardized bed assignments, improved nursing handoffs, and streamlined admission orders. This initiative significantly decreased patient wait times at the San Francisco VA Health Care System.

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Area of Science:

Healthcare Management
Process Improvement
Patient Flow Optimization

Background:

The San Francisco VA Health Care System experienced prolonged median admission delays (207 minutes), exceeding the national VA median (146 minutes).
Contributing factors included inefficient bed assignment, nursing handoff delays, and delayed initiation of admissions by inpatient teams.

Purpose of the Study:

To identify and address the root causes of extended patient admission delays.
To implement targeted interventions to improve patient throughput and reduce wait times.

Main Methods:

A multi-disciplinary team conducted a 6-month audit to analyze admission processes.
Three countermeasures were implemented: standardized bed assignment, improved nursing handoff protocols, and skeletal admission orders.

Main Results:

Median admission delay decreased by 29.5% (from 207 to 145 minutes) within 3 months post-intervention.
The observed reduction in admission delays was sustained over the study period.

Conclusions:

Standardizing bed assignments, optimizing nursing handoffs, and simplifying admission orders are effective strategies for reducing hospital admission delays.
These process improvements can significantly enhance patient flow and operational efficiency within healthcare systems.