SHM Converge Scientific Abstract ePoster Gallery-Enhancing Healthcare Efficiency: Strategies to Identify and Overcome Discharge Barriers to Optimize the Observed Over Expected (O/E) Ratio for Length of Stay (Los)

Enhancing Healthcare Efficiency: Strategies to Identify and Overcome Discharge Barriers to Optimize the Observed Over Expected (O/E) Ratio for Length of Stay (Los)

Back to course

Pdf Summary

The project focused on reducing non-medical discharge delays for hospitalized patients by using daily discharge rounds and a discharge planning template. The aim was to increase daily discharges by 20% and improve the observed-to-expected (O/E) length of stay ratio within 12 months.<br /><br />The authors noted that discharge delays can come from barriers such as pending imaging or procedures, delayed consultant, PT/OT, or placement recommendations, DME needs, transport problems, or unclear “medical clearance.” To address this, they introduced 14:00 discharge rounds, where provider teams and care coordination reviewed patient lists together to identify and resolve barriers earlier in the day. They also created a standardized discharge planning template, built into the Epic smartphrase system, to improve documentation clarity in progress notes and history and physical notes.<br /><br />A retrospective analysis was performed on expected discharges from November to December 2022. The team reviewed which patients were actually discharged versus those who remained hospitalized and examined the reasons for delay. Common barriers identified included medical clearance issues, placement to SAR/SNF/PCH/13A, imaging or procedure delays, and pending consultant recommendations.<br /><br />The project aimed to use this information to shorten length of stay, improve patient flow, increase bed availability, and optimize the hospital’s O/E ratio. Overall, the initiative emphasized structured interdisciplinary communication and standardized discharge planning as practical tools to reduce avoidable discharge delays.

Asset Subtitle

Shaheen Fatima

Meta Tag

Author List Brenda Patterson, Jung Park, Mary Ann K. Hall, Nova John, Rachel Mather, Shaheen Fatima, Sherri Bogard, Stacey Watkins, TaRessa Wills, Terralyn White

Category Research

Concept Discharge Barrier

Concept Delay

Concept Length of Stay

Concept Discharge Planning Template

Concept Observed-to-Expected Length of Stay

Distinguished Non-Finalist

Presenter Organization Emory University School of Medicine

Presenting Author Shaheen Fatima

Track Quality Improvement

Keywords

discharge delays

hospitalized patients

daily discharge rounds

discharge planning template

length of stay

patient flow

interdisciplinary communication

Epic smartphrase

observed-to-expected ratio

care coordination

Discharge Barrier

Delay

Length of Stay

Discharge Planning Template

Observed-to-Expected Length of Stay