SHM Converge Scientific Abstract ePoster Gallery-Complex Cases Rounds

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Complex Cases Rounds (CCRs) were introduced in November 2021 at Emory Johns Creek Hospital to improve length of stay (LOS) and clarify care plans for hospitalized patients with LOS over 6 days. The rounds are a multidisciplinary process led by the medical director of care coordination, with the hospitalist and social worker reviewing selected patients every Tuesday and Friday. Patients are identified one day in advance so the team can assess discharge barriers and prepare interventions.<br /><br />During CCRs, the team discusses discharge needs, the current plan of care, anticipated discharge date, expected level of care after discharge, barriers to discharge, and required actions. The purpose is to identify and address obstacles early, including medical instability, difficulty finding placement in rehabilitation or home care settings, challenging patient or family behaviors, lack of insurance, and delays in labs, procedures, or imaging.<br /><br />After implementing CCRs, the team discovered common sources of delay that were previously underrecognized. These included poor communication and delayed plan-of-care decisions from subspecialists, delays in intravenous orders such as IV antibiotics and total parenteral nutrition, and difficulty arranging specialized post-discharge services like home nursing and wound care.<br /><br />The initiative has reduced the number of patients with LOS greater than 6 days from about 55 at the start to a typical census of 30. Overall, CCRs have improved early identification of discharge barriers and enabled the team to develop strategies to reduce delays and support timely discharge to the appropriate level of care.

Asset Subtitle

Ingrid M. Pinzon

Meta Tag

Author List Ingrid M. Pinzon

Category Innovations

Concept Complex Cases Rounds

Concept Discharge Barrier

Concept Length of Stay

Concept Care Plan

Concept Discharge Planning

Distinguished Non-Finalist

Presenter Organization Emory Johns Creek Hospital

Presenting Author Ingrid M. Pinzon

Track Transitions of Care

Keywords

Complex Cases Rounds

length of stay

discharge planning

multidisciplinary rounds

hospitalized patients

care coordination

discharge barriers

subspecialist delays

post-discharge services

timely discharge

Complex Cases Rounds

Discharge Barrier

Length of Stay

Care Plan

Discharge Planning