Background: Geographic localization is the practice of assigning physician and advanced practice provider teams to patients located in the same inpatient unit. Poor localization of hospital medicine teams at our institution was identified as a top cause of increased Emergency Department boarding and Length Of Stay (LOS). The purpose of our process improvement project is [...]

Background: Discharging complex patients at an academic tertiary care center requires comprehensive evaluation, interprofessional coordination, and meticulous planning to address what is needed to ensure safe and timely discharges. Misalignment across care team members on discharge needs and barriers can lead to a delayed discharge which may result in poor patient satisfaction, increased task burden [...]

Background: Improving hospital throughput is critical to optimizing patient flow and capacity, particularly during periods of high census and ED boarding which can adversely impact patient experience and have downstream safety implications. Prolonged length of stay may result from inadequate alignment among care team members on patients expected to discharge, insufficient communication of discharge barriers, [...]

Background: Traditional Length of Stay (tLOS) is commonly used in Hospital Medicine to assess hospital resource utilization and to incentivize reductions in patient stays. However, tLOS is often attributed to the discharging physician, which can lead to attribution errors and fairness concerns. These limitations can reduce the metric’s utility. In response, Pierce, Harrison, and Patel [...]

Background: Improving hospital throughput and capacity is a challenge that many health systems face. Specifically, emergency room overcrowding leads to delayed access to treatment and increased mortality, thereby negatively impacting patient safety (Franklin, et al., 2023). Health systems strive to employ multiple strategies to tackle the issues around patient flow. One such strategy includes the [...]

Background: As a strategy to address its ongoing capacity crisis, our hospital has focused on reducing length of stay and improving throughput. Our hospitalists care for patients on >20 nursing units across four buildings, which creates inefficiencies that may prolong length of stay. Although other institutions have demonstrated improved patient flow by geographically cohorting patients [...]

Background: Vanderbilt University Hospital continues to experience a capacity crisis, leading to a focus on strategies to improve patient flow and length of stay. Other institutions have demonstrated improved throughput by geographically cohorting patients and their respective care teams. Purpose: To reduce hospital length of stay and increase early discharges through the implementation of a [...]