Background: Improving hospital throughput is a barrier facing medical facilities.  Poor throughput leads to prolonged patient wait times for beds, a cause of patient complaints.  Often these wait times are the result of late discharge times for admitted patients.  One focus of multidisciplinary rounds is early discharge, hoping to get admitted patients to their beds [...]

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: The discharge process has been identified as a choke point for efficient patient flow through the hospital1,2. Delayed discharges have been associated with ER overcrowding, increased length of stay, and increased risk for patient harm1-4. Early discharge initiatives such as discharge by noon have been adopted by hospital systems as a way to improve [...]

Background: Hospital crowding and subsequent resource strain have been associated with worse patient outcomes and increased length of stay (1–3). As pediatric hospitals face an overwhelming respiratory illness surge in the wake of the COVID pandemic (4–6), improving hospital patient flow is all the more critical. Nonetheless, a substantial proportion of patients, nearly 1 in [...]

Background: Late discharges are associated with hospital overcrowding, delayed inter-unit patient transfers, lower patient satisfaction scores and longer length of stay. At our hospital, there has been a consistent discordance between the teaching and non-teaching hospitalist services in the percentages of patients discharged before 11 am, which was 8.4% (teaching teams) versus 36.4% (non-teaching teams) [...]

Background: Late discharges are a known barrier to patient flow.  Our project was to identify barriers to early discharges and develop processes to increase early discharges from the inpatient medicine teams.   Purpose:  “Daily afternoon multidisciplinary team huddles will increase the % of discharge orders before 10am by 10% on the medicine teams by June 2015” Description: We initially analyzed reasons [...]

Background: Prioritizing hospital discharges to improve throughput and safety is a common theme in hospital systems. More recently, there has been an increasing importance placed on early discharges. Earlier discharges help to improve flow for admitted patients through the emergency department. In addition, by expediting patient care, patients are able to have their questions answered [...]

Background: Both inappropriate hospital admissions and inappropriate discharges from the ED are associated with adverse patient outcomes. Little is known about the accuracy (sensitivity and specificity) of the hospital admission triage process. Purpose: We sought to understand the operating characteristics of our triage process to identify opportunities for improvement and project an optimal model. Description: [...]

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 [...]