SHM Converge Scientific Abstract ePoster Gallery-Enhancing Care Coordination and Reducing Length of Stay Through Medical Readiness Smartphrase and Milestone Technology

Pdf Summary

This project addressed a common inpatient care problem: physicians often document anticipated discharge timing and care needs, but this information is hard to find and is missed during multidisciplinary rounds, especially when physicians cannot attend consistently. At the authors’ institution, this led to poor visibility of the plan of care, more messaging between team members, and delays in patient progression.<br /><br />To improve communication, the team adapted a new EMR feature called “Milestones” and linked it to a physician smartphrase used in daily notes. The smartphrase prompts providers to enter two items: the patient’s anticipated medical clearance date and any pending discharge milestones. The clearance date is selected from preset time frames such as Ready Now, Today, Tomorrow, 2–4 days, and 5 days. The milestone options include common barriers to discharge such as rehab therapy, imaging, home oxygen evaluation, case management, consult sign-off, and follow-up appointments. Downstream workflows were created so the appropriate teams could complete each milestone, many of them automatically.<br /><br />The smartphrase was introduced to two hospitalist groups and encouraged in H&P and progress notes. After 8 weeks, the pilot showed a decrease in length of stay of 0.5 days for inpatient patients and 0.1 days for observation patients. Feedback indicated the tool was easy to use but hard to remember consistently. Clinical teams found the added visibility helpful for prioritizing care.<br /><br />Overall, the authors conclude that a simple EMR smartphrase can improve transparency around discharge planning and may help reduce length of stay when combined with well-designed team workflows.

Asset Subtitle

Colleen McIntosh

Meta Tag

Author List Amit Patel, Colleen McIntosh, Jaimie Weber

Category Innovations

Concept MiCast Smart Phrase

Concept Estimated Discharge Date

Concept Hospital Length of Stay

Concept EMR Milestone

Concept Medical Readiness Smartphrase

Distinguished Non-Finalist

Presenter Organization University of South Florida

Presenting Author Colleen McIntosh

Track Technology in Hospital Medicine

Keywords

discharge planning

electronic medical record

smartphrase

milestones

length of stay

inpatient care

care coordination

multidisciplinary rounds

physician communication

patient discharge

MiCast Smart Phrase

Estimated Discharge Date

Hospital Length of Stay

EMR Milestone

Medical Readiness Smartphrase