SHM Converge Scientific Abstract ePoster Gallery-Core Functions and Forms of a Discharge by Noon Program

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The document describes a study of a “Discharge By Noon” (DBN) program implemented on hospital medicine teams at the University of Michigan and an affiliated unit at Trinity Health Ann Arbor. Because morning discharge initiatives can improve patient flow and satisfaction but may fail in real-world settings without strong coordination, the team framed DBN as a complex health intervention.<br /><br />To understand how the program works, the researchers reviewed existing implementation materials and surveyed multidisciplinary stakeholders involved in DBN. The interviews examined the patient/system need the intervention was meant to address, the purpose of each intervention component, which elements were essential to success, and what conditions were needed for implementation. Survey responses were coded to create a DBN Function and Form matrix, and all steps in the priority discharge process had been shared before survey completion.<br /><br />Twenty-two of 23 stakeholders responded. The resulting matrix organized DBN into three parts: the problems the care model addresses, standardized core functions, and customizable forms. The team identified 11 core functions that addressed 6 motivating needs. Representative examples of forms were included to show how each core function could be implemented in practice.<br /><br />Overall, the study concludes that the DBN Functions and Forms matrix provides a theory-based explanation of how the intervention achieves its effects. It can also help evaluate fidelity by checking whether all core functions are present. Importantly, it supports dissemination and scaling by distinguishing between functions, which must remain consistent, and forms, which can be adapted to local settings.

Asset Subtitle

Megan Mack

Meta Tag

Author List David Paje, Jigisha Patel, Megan Mack, Paul Caseley, Ruby Marr, Stephanie Taylor

Category Research

Concept Discharge By Noon Program

Concept Core Functions

Concept Capacity Strain

Concept Patient Throughput

Concept Complex Health Intervention

Distinguished Non-Finalist

Presenter Organization University of Michigan Department of Internal Medicine

Presenting Author Megan Mack

Track Quality Improvement

Keywords

Discharge By Noon

DBN program

hospital medicine

patient flow

patient satisfaction

implementation science

health intervention

fidelity assessment

core functions

dissemination scaling

Discharge By Noon Program

Core Functions

Capacity Strain

Patient Throughput

Complex Health Intervention