Background: Late afternoon hospital discharges contribute to admission delays, leading to occupancy increase and increased length of stay. However, prominent workplace barriers often exist towards improvement initiatives that target early discharge. Team members cite timing of rounds, absence of early discharge support resources, communication breakdowns, and increased daytime admission volume as barriers to change. Furthermore, […]

Background: Improvement of discharge times on house staff run medical floors is particularly complicated. Amato-Vealey et al. describe a domino effect of delayed discharges resulting in inability to transfer patients from intensive care units, advancement towards maximum capacity, and failure to move patients from the ER. This leads to delayed procedures, poor patient satisfaction, and […]

Background: The timing of discharges of admitted patients has a significant impact on hospital efficiency and throughput. Earlier discharges are associated with improved boarding times, admissions arriving to inpatient units earlier in the day, and decreased length of stay. Discharges that occur later in the day creates a bottleneck effect, causing emergency room congestion, overcrowding, […]