Background: Making the hospital discharge process faster and more predictable may help improve patient flow, reduce delays in admitting new patients, and increase hospital capacity. Some hospitals have implemented initiatives to promote timelier discharges as ways to improve hospital throughput.  We conducted a national survey of academic medical centers addressing the prevalence, importance, and effectiveness [...]

Background: Preventable hospital readmissions are a common problem for medical centers in the United States. Recent studies have focused on what patients perceive as causes for their return to the hospital. One factor driving readmissions is patients’ difficulty anticipating what to expect after they leave the hospital despite discharge instructions, especially anticipating and surmounting challenges [...]

Background: To date, there are limited reports around the use of well-designed information technology tools to enhance communication during interdisciplinary rounds (IDRs). Computer supported cooperative work (CSCW) is a field that studies the integration of information technology into the workflow of healthcare teams. In collaboration with our technology innovations center, we developed a Microsoft Teams [...]

Background: In November 2021, we initiated a project to improve our length of stay (LOS) and plan of care for patients with a LOS of ≥6 days. We created the Complex Cases Rounds (CCRs) for all patients hospitalized under the hospital medicine service in our community hospital, Emory Johns Creek Hospital. Purpose: CCRs provide a [...]

Background: Medically stable patients with barriers to discharge in the acute care setting are a growing proportion of hospitalized patients throughout the nation at a time when many hospitals are experiencing both bed and healthcare worker shortages. These patients remain bedded across various acute units in the hospital, reducing bed availability and staffing for more [...]

Background: Hospitals are facing increasing pressure to optimize throughput in order to reduce excess length of stay and improve emergency department (ED) boarding times. Improving coordination and throughput in complex organizations with multiple care sites can be particularly challenging. Health systems have implemented numerous initiatives to improve hospital throughput, but these efforts have mainly been [...]

Background: Identifying discharge barriers, reducing length of stay (LOS) and optimizing the observed over expected (O/E) ratio for LOS are crucial in healthcare management. Addressing obstacles—DME needs, medical issues, diagnostic/procedure delays, administrative hurdles—can streamline discharge, enhancing outcomes, optimizing resources, cutting costs, and improving hospital efficiency. Effective discharge planning, interdisciplinary collaboration, and patient education are vital [...]

Background: Discharge delays are associated with excessive costs to healthcare systems and poor patient outcomes. We sought to identify perceived barriers to timely discharge within and outside the control of hospitalists from the multidisciplinary team pivotal to the discharge process, and if different professionals noted different barriers. Methods: In June 2024, we surveyed hospitalist physicians/advanced [...]

Background: Length of stay is an important marker for quality of care in the hospital. Increased length of stay can affect patient flow through the hospital and can lead to overcrowding, increased boarding in the emergency department, delays in inter-hospital transfer, and cancellation of elective procedures due to bed availability (1). In addition, longer hospitalizations [...]

Background: Since 2020, UNC Hospitals has increasing numbers of patients who no longer require acute level of care. A portion of these patients have longer length of stay exceeding 30 days while awaiting disposition. This is noticeable in our percentage of long length of stay patients hospitalized 31-60 days (6.8% in 2022 vs 6.0% in [...]