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: Limited hospital capacity continues to be one of the major challenges to health care in hospitals in the US and the developed world. This problem manifests in a variety of ways in multiple settings starting with prolonged emergency room wait times and left without being seen rates, prolonged ED boarding time, and elective surgery [...]

Background: Emergency department (ED) overcrowding is associated with a range of negative outcomes, including increased patient morbidity, decreased patient satisfaction, provider burnout, and violence against providers. ED boarding of admitted patients coupled with increasing ED patient volumes contributes to overcrowding. Geographic localization, where hospitalist provider teams are assigned patients on the same inpatient unit, has [...]

Background: Hospitals increasingly face capacity strain and challenges with patient flow, leading to emergency department (ED) crowding, ED boarding, and threats to patient safety and quality of care. ED boarding occurs from the time of the decision to admit until the patient arrives in an inpatient bed and is affected by many factors including discharge [...]

Background: Emergency department (ED) overcrowding is a commonly encountered challenge and is associated with adverse events and poor patient satisfaction.  One of the factors that can contribute to ED overcrowding is the boarding of admitted patients in the ED. Various methods have been implemented to improve this issue with limited success.     Purpose: A collaborative workgroup [...]

Background: Efficient discharge planning for hospital medicine patients requires alignment across multiple disciplines. Understanding how clinicians communicate information about discharge readiness can identify opportunities to improve discharge coordination and impact length of stay, hospital capacity, and patient satisfaction. The objective of this study was to outline the existing information gathering and communication pathways around discharge [...]

Background: Hospital medical groups use various staffing models which systematically affect care continuity during the admission process. Our service changed models of care from a “general model”, where hospitalists who perform hospital rounds and discharges also perform admissions on the same service day, to an “admitter-rounder model”, where service work is divided each day between [...]

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: Hospital throughput and length of stay (LOS) are important drivers of success in an increasingly competitive healthcare landscape where revenues are down and demand can exceed hospital capacity. More specifically, longer LOS and hospital throughput bottlenecks impact access to timely care, the quality and safety of care delivery, patient and family satisfaction, and provider [...]

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 [...]