Eric Linson, class of ’17, Ethan Kuperman, MD, and Kevin Glenn, MD, recently received first place in the innovations category for their early discharge poster at the Midwest Regional Meeting of the Society of General Internal Medicine, in Cleveland, Ohio.
Over two hundred posters were presented by faculty and students across three categories: scientific abstracts, innovations, and clinical vignettes. Iowa’s early discharge poster was recognized over several posters from the University of Chicago, Mayo Clinic, and Cleveland Clinic. See all of the 2016 Midwest awards.
Inpatient discharge is an important limitation on patient admission and a frequent area of patient dissatisfaction. Expediting discharge is often used to alleviate increasing demand for inpatient beds, but its effect on hospital flow has been controversial. The poster titled, “Facilitating early discharge with interprofessional team-based practice enhances the patient experience and improves hospital flow,” demonstrated that an interprofessional team of physicians, nurses, patient navigators, social workers, and pharmacists was able to identify patients eligible for early discharge and improve hospital patient flow and patient satisfaction with the discharge process.
Four inpatient medicine physician teams were asked to identify patients likely to discharge the following day from one of two 48-bed inpatient nursing units. An interprofessional team including patient navigators, pharmacists, social workers, and charge nurses discussed these patients using a discharge checklist during an afternoon discharge huddle. Each team member had specific roles within the discharge process. Ten months of admission, discharge, and transfer (ADT) data was assessed to determine baseline performance of each of the four inpatient physician teams. Patient satisfaction with discharge was assessed by third party surveys in a similar manner. Performance based on the number of discharges before 11 a.m. was reported out weekly.
After 6 months, the majority (56 percent, n=421) of identified patients were discharged on the expected day. Patient discharges before 11 a.m. increased from 6.0 percent (n=2435) to 13.6 percent (n=1643) following intervention.
Overall, average discharge time improved 37 minutes from 3:01 p.m. to 2:24 p.m., while average admission time was reduced 19 minutes from 1:28 p.m. to 1:08 p.m.
Patient satisfaction with the speed of the discharge process improved from a peer percentile rank of 7 (n=108) to a percentile rank of 56 (n=89).