Background: Efficient discharge planning is crucial for improving hospital capacity strain and patient care. Multidisciplinary rounds (MDRs) have demonstrated effectiveness in enhancing communication and care coordination, but their impact on resident teaching teams has been less studied. The expected discharge date (EDD), among other key metrics in discharge efficiency, helps predict bed capacity, optimize patient flow, and ensure timely transitions through better resource allocation.
Methods: We conducted a retrospective study at The Queen’s Medical Center comparing two resident multidisciplinary teaching (MDT) teams that included dedicated CMs and SWs with two standard care teams over eight months (October 18, 2023 – June 25, 2024). The outcomes assessed included length of stay (LOS), expected discharge date (EDD) accuracy, readmission rates, and the rate of conditional discharge orders placed. Additionally, we administered a voluntary, electronic 3-part survey to the resident trainees from The University of Hawaii Internal Medicine Residency Program (UHIMRP) to gather feedback on their experiences working with MDT members.
Results: A total of 1944 patients were included. The MDT teams showed significantly improved EDD accuracy (72.0% vs. 66.7%, p = 0.0120) and more frequently placed conditional discharge orders (61.7% vs. 43.8%, p < 0.0001) compared to standard care teams. Among 38 survey respondents (65.5% response rate), 68.4% reported experience with the MDT teams. Over 65% of respondents stated that their ability to identify discharge barriers and facilitate timely discharges had “markedly increased” compared to six months earlier. Additionally, 67.6% of residents reported CM/SW continuity “Significantly” improved patient care, 50% reported CM/SW interactions allowed “Significantly” increased time for education, and 67.7% reported CM/SW coordination of disposition issues allowed residents to spend “Moderately” or “Significantly” more time for patient care. 74.9% of the residents correctly delineated the CM and SW roles and responsibilities.
Conclusions: Embedding dedicated CMs and SWs in resident teaching teams enhances discharge planning efficiency by improving EDD accuracy and increasing the use of conditional discharge orders. Residents also reported improved ability to identify and address discharge barriers, enhanced patient care, more time for educational activities and patient interactions, and greater clarity regarding CM and SW roles. These findings support the integration of MDRs into IM residency programs to optimize discharge planning and resident education.