SHM Converge Scientific Abstract ePoster Gallery-A Tool to Track Inpatient Days Awaiting Safe Discharge

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The document describes the creation of an “Awaiting Safe Discharge” (ASD) tool in the Epic electronic medical record to identify patients who are medically ready for discharge but remain hospitalized because of barriers such as placement delays, insurance issues, post-acute care needs, homelessness, guardianship, or rehabilitation arrangements.<br /><br />The main motivation for the tool is that hospitals need to reduce length of stay for patients who no longer require acute care, but there has been no standard EMR time-point to clearly mark when a patient becomes discharge-ready. This makes it difficult to escalate barriers in real time, track delayed discharges, and support quality improvement efforts.<br /><br />The ASD field was added under the Admission, Transfer, and Discharge tabs and can be used by physicians, advanced practice providers, case managers, and social workers. During multidisciplinary rounds, staff are asked to click “Yes” for patients who are medically ready for discharge. When marked “Yes,” the patient automatically appears on a templated multidisciplinary patient list, helping teams focus discussions on discharge planning. These patients are also highlighted in twice-weekly barrier meetings with care coordination leadership.<br /><br />The tool is also used for reporting and operational awareness, including tracking the number and reasons for delayed discharge days. Since its rollout in July 2022, utilization has increased, with more “Yes” and “No” responses being recorded over time.<br /><br />The authors conclude that the ASD tracking tool helps stakeholders identify medically ready patients in real time, support resource allocation, strengthen coordination, and potentially reduce hospital length of stay.

Asset Subtitle

Ting-Jia Lorigiano

Meta Tag

Author List Andrew Hughes, Carrie Herzke, Kimiyoshi J. Kobayashi, Margueritta El Asmar, Shanshan Huang, Steven McGaffigan, Suzanne Fockler, Ting-Jia Lorigiano

Category Innovations

Concept Awaiting Safe Discharge

Concept Discharge Barrier

Concept Delayed Discharge

Concept Discharge Readiness

Concept Hospital EMR

Distinguished Non-Finalist

Presenter Organization Johns Hopkins Hospital

Presenting Author Ting-Jia Lorigiano

Track Value in Hospital Medicine

Keywords

Awaiting Safe Discharge

ASD tool

Epic electronic medical record

discharge-ready patients

length of stay

discharge barriers

care coordination

multidisciplinary rounds

post-acute care

hospital discharge delays

Awaiting Safe Discharge

Discharge Barrier

Delayed Discharge

Discharge Readiness

Hospital EMR