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: Multidisciplinary (MDR) team rounds were established at Halifax hospital as daily, dedicated interactions between varying members of the care team on each inpatient floor. Members of the care team include physicians, nurses, physical therapists, pharmacists, and case managers. These multidisciplinary interactions allow for smooth, real-time, and accurate information that facilitate communication and enhance the [...]

Background: Sickle cell disease (SCD) causes frequent painful episodes from vaso-occlusion. As hospitalists, we identified that SCD patients occupied a large number of hospital days. Undertreatment and lack of standardization of pain management was a likely reason for this. Many of these patients are opiate dependent at baseline. Varying levels of comfort amongst hospitalists in [...]

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: Length of Stay (LOS) can provide important information regarding the efficiency and quality of patient care. Often, LOS is used as a proxy of efficient hospital management because reducing LOS can allow capacity for emergent admissions and interhospital transfers.2 Increased LOS is associated with negative patient outcomes including increased risk for mortality, hospital acquired [...]

Background: A recent uptick in hospital readmissions, prolonged lengths of stay that was above national benchmarks, and declining patient satisfaction scores threatened the institution’s reputation within the community and risked CMS reimbursement penalties. In response, an interdisciplinary physician-led huddle followed by a structured nurse-physician bedside rounding protocol was developed. This approach was designed to strengthen [...]