SHM Converge Scientific Abstract ePoster Gallery-Acute Transition Care Program: A New Patient Care Delivery Model

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Nebraska Medicine implemented an Acute Transition (AT) Care Program to address bed shortages, discharge delays, and nursing strain in its 809-bed academic medical center. The quality improvement project targeted medically stable adult patients whose acute needs were low but who remained hospitalized due to placement or discharge planning delays.<br /><br />The program created a dedicated 20-bed unit with a redesigned care model. Eligible patients were adults age 19 or older, medically stable, low-acuity, and expected to remain at least two more days. Daily screening was done by the Nursing Resource Coordinator and lead RN using EHR reports and acuity assessments. The AT unit used reduced routine nursing interventions, including vital signs, full-body assessment, intake/output once per shift, weekly weights, and a “do not disturb” period from 10 p.m. to 6 a.m. Staffing ratios were adjusted to 1:8 on day shift and 1:10 on night shift.<br /><br />Results showed the model improved efficiency without compromising safety. The pilot unit remained 100% occupied and reported no patient safety events. Nursing workload and documentation were considered manageable, staffing ratios were viewed as appropriate, and staff expressed willingness to care for this population again. Compared with the typical med-surg model, nursing hours per patient were reduced from 5.4 to 2.7 daily, generating an estimated 412.5 hours saved in one month and a projected annual savings of 6,023 hours, or about $789,013.<br /><br />Overall, the AT Care Program increased availability of acute care beds, lowered nursing costs, improved staff satisfaction, and was adopted permanently after a successful one-month pilot.

Asset Subtitle

Jennifer K. Scranton

Meta Tag

Author List Angela Boesch, Cassandra Smith, Emma Nohr, Jennifer K. Scranton, Keri Leach, Shelby Hackett, Susan Barnason, Tabatha Matthias

Category Innovations

Concept Acute Transition Care Program

Concept Delayed Discharge

Concept Eligibility Criteria

Concept Acute Transition Unit

Concept Patient Safety

Distinguished Non-Finalist

Presenter Organization Nebraska Medicine

Presenting Author Jennifer K. Scranton

Track Quality Improvement

Keywords

Nebraska Medicine

Acute Transition Care Program

bed shortages

discharge delays

nursing strain

medically stable patients

low-acuity adult patients

dedicated 20-bed unit

nursing workload reduction

acute care efficiency

Acute Transition Care Program

Delayed Discharge

Eligibility Criteria

Acute Transition Unit

Patient Safety