SHM Converge Scientific Abstract ePoster Gallery-Continuous Quality Improvement Opportunities in an Oncology Hospital Medicine Practice

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This study examined opportunities for quality improvement on an inpatient oncology hospitalist service by analyzing 1,131 admissions across 765 patients from July 2021 to March 2022. The authors evaluated length of stay, discharge timing, and 30-day readmission rates, using multivariable models adjusted for patient and disease factors.<br /><br />Key findings showed that admission frequency was not associated with age, sex, race/ethnicity, cancer type, or insurance status. However, several factors were linked to longer hospitalization and later discharge. Patients with head and neck cancer had the longest stays, with six admissions ranging from 43 to 112 days, contributing to a mean length of stay about 2 days longer than other cancers. Higher severity of illness was associated with about 2 additional hospital days and later discharge in the day. Discharge to a skilled nursing facility was associated with a 5-day longer stay and discharge about 1.25 hours later than discharge home.<br /><br />Discharge disposition was also strongly related to 30-day readmission rates. Patients discharged home or to skilled nursing facilities had readmission rates around 31% to 35%, while patients discharged to hospice had very low readmission rates, under 2%.<br /><br />The study concludes that barriers to timely discharge are especially present for patients with head and neck cancers, greater illness severity, and those requiring skilled nursing facility placement. Expanding hospice referrals may reduce inpatient days near the end of life and offer a clear target for continuous quality improvement.

Asset Subtitle

Bonnie E. Gould Rothberg

Meta Tag

Author List Bonnie E. Gould Rothberg, Elizabeth Prsic, Erin A. Gombos, Jensa C. Morris, Kerin B. Adelson, Mathew J. Kottarathara, Nathaniel A. Parker, Urs M. Weber

Category Research

Concept Inpatient Oncology

Concept Length of Stay

Concept Discharge timing

Concept Readmission Rate

Concept Disease Severity

Distinguished Non-Finalist

Presenter Organization Northeast Medical Group

Presenting Author Bonnie E. Gould Rothberg

Track Quality Improvement

Keywords

inpatient oncology

quality improvement

length of stay

discharge timing

30-day readmission

head and neck cancer

severity of illness

skilled nursing facility

hospice referral

hospitalist service

Inpatient Oncology

Length of Stay

Discharge timing

Readmission Rate

Disease Severity