Background: Length of stay (LOS) outliers are a focus of cost and resource utilization for hospitals in the United States. Limited research has been done to characterize outliers, risk factors, and barriers to discharge. Methods: We conducted a case-control study of inpatient admissions to the general medicine service line between September 2015 and August 2016. [...]

Background: Prolonged lengths of stay (PLOS) on general internal medicine wards are associated with increased mortality and morbidity for patients and represent a costly source of health care spending [1]. Increasingly, nonmedical barriers to discharge, including the need for guardianship, limited facility options, and lack of home support are recognized as contributors to PLOS in [...]

Background: Increased hospital capacity causes significant strain on medical institutions. Patients who are clinically ready for discharge but “stuck” awaiting post-acute resources are thought to contribute to this capacity strain. Here, we aim to provide a clinically relevant measurement of the prevalence (proportion of patients) and weight (proportion of days) for patients who have spent [...]

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: As healthcare costs continue to burgeon and grow at an unprecedented rate, cost utilization is an increasingly important field of research. In-hospital costs are one of the most expensive contributors to healthcare costs in the United States. Very little research has been done in the United States regarding length of stay outliers and their [...]

Background: While hospitals are primarily designed to provide acute care, a subset of patients have prolonged lengths of stay beyond medical necessity for months on general medicine wards[1]. These cases often occur in vulnerable patient populations, including those with mental health and substance use disorders[2], impaired decision-making capacity[3, 4], and housing insecurity[3]. However, few studies [...]

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 [...]