Journal ArticleDOI
Discharge Rounds: Implementation of a Targeted Intervention for Improving Patient Throughput on an Inpatient Medical Teaching Service.
TLDR
A targeted intervention can significantly improve early discharges and should be replicable at other academic medical centers, however, reinforcement is needed for these gains to be sustainable.Abstract:
OBJECTIVES Patient throughput and early discharges are important for decreasing emergency department wait times and creating available beds for new hospital admissions. The educational schedule of internal medicine trainees can interfere with timely discharges, but targeted interventions can help residents meet the hospital's patient flow needs. Our training program instituted daily morning discharge rounds on the inpatient service, requiring each team to prepare potential discharges 1 day ahead and prioritizing these discharges the next day. METHODS We conducted a retrospective, pre-post analysis 1 month before and 3 months after implementation in August 2013 to assess discharge order entry times, the proportion of discharges before 11:00 am, and hospital departure times. RESULTS One month post-implementation, discharge orders were entered 59 minutes earlier (from 1:07 pm to 12:08 pm; P = 0.001), the percentage of pre-11:00 am discharges increased from 21% to 39% (P < 0.01), and patients departed the hospital 50 minutes earlier (from 3:21 pm to 2:31 pm; P = 0.005). These effects, however, returned to pre-implementation times during the subsequent 2 months. CONCLUSIONS A targeted intervention can significantly improve early discharges and should be replicable at other academic medical centers. Reinforcement is needed for these gains to be sustainable, however.read more
Citations
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Journal ArticleDOI
A Lean Six Sigma Quality Improvement Project Improves Timeliness of Discharge from the Hospital.
Mithu Molla,Duncan S. Warren,Susan L. Stewart,Jacqueline C. Stocking,Hershan Johl,Voltaire Sinigayan +5 more
TL;DR: A QI program shaped by Lean Six Sigma principles and reinforced by clinician huddles and geographic cohorting was associated with earlier posting of discharge orders and physical discharge by noon and no significant changes in the 30-day readmission rate or length of stay.
Journal ArticleDOI
A Comprehensive Risk Score to Predict Prolonged Hospital Length of Stay After Heart Transplantation.
Todd C. Crawford,J. Trent Magruder,Joshua C. Grimm,Alejandro Suarez-Pierre,Nishant D. Patel,Christopher M. Sciortino,Kenton J. Zehr,Kaushik Mandal,Ryan J. Tedford,Stuart D. Russell,John V. Conte,Robert S.D. Higgins,Duke E. Cameron,Glenn J. Whitman +13 more
TL;DR: The prolonged hospitalization after heart transplant score may lead to individualized postoperative management strategies to reduce duration of hospitalization for patients at high risk of PLOS.
Journal ArticleDOI
Improving Patient Flow: Analysis of an Initiative to Improve Early Discharge.
Lauren Destino,Denise Bennett,Matthew Wood,Christy Acuna,Stephanie Goodman,Steven M. Asch,Terry Platchek +6 more
TL;DR: A multimodal intervention was associated with more EDCs and decreased PACU and ED bed wait times, and a pre/postintervention retrospective analysis found.
Journal ArticleDOI
Team-Based Care: The Changing Face of Cardiothoracic Surgery.
TL;DR: An overview of a team-based, patient-centric "systems" approach to the care of cardiothoracic surgery patients is provided.
Proceedings ArticleDOI
Data-driven generic discrete event simulation model of hospital patient flow considering surge
TL;DR: A generic, data-driven, discrete event simulation (DES) is developed to help hospitals assess the impact of hospital-wide decisions, including surge policies, on congestion.
References
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Journal ArticleDOI
The relationship between inpatient discharge timing and emergency department boarding.
Emilie S. Powell,Rahul K. Khare,Arjun K. Venkatesh,Ben D. Van Roo,James G. Adams,Gilles Reinhardt +5 more
TL;DR: Timing of inpatient discharges had an impact on the need to board admitted patients, and this model demonstrates the potential to reduce or eliminate ED boarding by improving inpatient discharge timing in anticipation of the daily surge in ED demand for inpatient beds.
Journal ArticleDOI
“July Effect”: Impact of the Academic Year-End Changeover on Patient Outcomes: A Systematic Review
Journal ArticleDOI
Use of multidisciplinary rounds to simultaneously improve quality outcomes, enhance resident education, and shorten length of stay.
Stephen P. O’Mahony,Stephen P. O’Mahony,Eric M. Mazur,Eric M. Mazur,Pamela Charney,Pamela Charney,Yun Wang,Jonathan M. Fine +7 more
TL;DR: Resident-centered MDR is an effective process using no additional resources that simultaneously improves quality of care while enhancing resident education and is associated with shortened length of stay.
Journal ArticleDOI
Discharge before noon: An achievable hospital goal
Benjamin Wertheimer,Ramon E. A. Jacobs,Martha Bailey,Sandy Holstein,Steven Chatfield,Brenda Ohta,Amy Horrocks,Katherine Hochman +7 more
TL;DR: This study demonstrates that increased DBN is an achievable and sustainable goal for hospitals and that future work will allow for better understanding of the full effects of such an intervention on patient outcomes and hospital metrics.
Journal ArticleDOI
Patient and hospital characteristics associated with recommended processes of care for elderly patients hospitalized with pneumonia: results from the medicare quality indicator system pneumonia module.
TL;DR: Minority race, fever, nurse-bed ratio, hospital size and teaching status, and southern location are among the major patient and hospital characteristics associated, either negatively or positively, with the timeliness of performance of initial antibiotic administration and blood culture collection for patients hospitalized with pneumonia.