SHM Converge Scientific Abstract ePoster Gallery-Breaking the Barriers: A Clinical Assistant-Led Initiative to Identify and Address Discharge Barriers in Hospital Medicine

Pdf Summary

This initiative described the “Accelerated Discharge Program” (ADP), a Clinical Assistant (CA)-led workflow designed to identify and address discharge barriers for hospitalized patients likely to leave within 24 hours. The problem was that complex discharges require coordination across multiple team members, but the institution lacked a centralized, proactive process to surface and resolve obstacles, contributing to delays, clinician burden, and reduced patient satisfaction.<br /><br />The ADP embedded a trained CA across 8–10 direct care teams. Hospitalists flagged patients nearing discharge, and the CA documented perceived barriers and outstanding tasks, then either completed tasks directly or communicated with the care team. Data were collected from October 2023 through September 2024 and reviewed monthly for quality assurance, with categories refined when needed to improve accuracy.<br /><br />Among 1,002 patient encounters where discharge within 24 hours was anticipated, 67% had identified discharge barriers. Most barriers were related to acute medical care, while others involved coordination or administrative issues such as placement, home services, equipment, insurance, caregiver issues, and inpatient transfer needs. In nearly 1 in 5 encounters, the CA helped resolve discharge-related tasks and improved interprofessional communication and teamwork. Common CA activities included follow-up coordination and outreach to patients or caregivers.<br /><br />The authors conclude that a CA-led discharge support model can provide useful infrastructure to proactively identify barriers, speed task completion, and streamline workflows so hospitalists can focus more on acute care. Future work will explore incorporating patient and caregiver perspectives into barrier identification and broader system-level solutions to improve throughput.

Asset Subtitle

Prashant Patel

Meta Tag

Author List Brandon S. Scott, Connie Li, Monisha Bhatia, Prashant Patel, Rachel Luke

Category Research

Concept Clinical Assistant

Concept Accelerated Discharge Program

Concept Discharge Barrier

Concept Hospital Discharge

Concept Discharge Task

Distinguished Non-Finalist

Presenter Organization Univeristy of California, San Francisco

Presenting Author Prashant Patel

Track Value in Hospital Medicine

Keywords

Accelerated Discharge Program

Clinical Assistant

discharge barriers

hospital discharge

workflow coordination

patient throughput

interprofessional communication

care coordination

quality assurance

hospitalist support

Clinical Assistant

Accelerated Discharge Program

Discharge Barrier

Hospital Discharge

Discharge Task