Background: Prolonged hospitalizations of patients who are medically ready for discharge are highly prevalent in the current acute care environment.1 Patients who remain in the hospital beyond resolution of their acute medical needs often have high medical, social and psychiatric complexity and are poorly served remaining in an environment that is not designed for their [...]

Background: Daily lab (DL) overuse in hospitalized patients leads to increased costs and resource utilization, iatrogenic anemia, and patient discomfort. Those awaiting discharge to post-acute care, who experience frequent non-medical delays in discharge, may represent an important group of patients at risk of receiving unnecessary DL, especially labs on day of discharge (LOD). Best Practice [...]

Background: Reducing hospital length of stay (LOS) for patients who are medically ready for discharge is both an operational necessity and a shared patient goal given fixed hospital capacities and rising costs of care. Presently, there is no readily identifiable time-point in the electronic medical record (EMR) denoting when patients become medically ready for discharge. [...]

Background: In July 2021, our institution launched the Better Flow Program, aimed at streamlining patient flow by documenting the Medically Ready for Discharge Date (MRDD) and the Discharge Delays (DDs) in the electronic medical record (EMR). The MRDD is the date at which a patient is deemed clinically stable for discharge by their medical team. [...]

Background: Discharge planning plays a critical role in managing hospital length of stay (1). We report on the implementation of a program in a large hospital system where health care providers were requested to estimate and record the Medically Ready for Discharge Date (MRDD) in the electronic health record (EHR) for hospitalized patients to facilitate [...]

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 [...]