SHM Converge Scientific Abstract ePoster Gallery-Expediting Delays in Inpatient Care Through Real-Time Central Intervention

Pdf Summary

A centralized inpatient expediter program was launched in the hospital command center to address delays in inpatient care, improve throughput, and reduce frustration for patients, families, and clinical teams. The program began as an email-based system that allowed clinicians to submit delay-related requests, which were then managed by rotating nurse bed managers. A network of stakeholders across imaging, procedures, anesthesia, care coordination, and home care helped resolve requests, while a tracking log monitored outcomes and impact. Results and trends were shared regularly with leadership and clinical groups, and a Care Progression Steering Committee was created with executive sponsorship.<br /><br />From October 2022 to October 2023, the program received 502 requests, with recent volume averaging 2–3 requests on weekdays. Most requests came from the Department of Medicine (86%), followed by Neurology (9%) and Surgery (5%). Residents submitted the majority of requests (64%), with attendings, advanced practice providers, case management/social work, and nursing contributing smaller proportions. Although the target turnaround time was 24 hours, 98% of requests were expedited the same day.<br /><br />The most common request types involved MRI (27%), procedures (12%), echocardiograms (10%), and discharge barriers such as durable medical equipment and home care (5–8%). Challenges included limited staff and resources, variation in ordering practices, and difficulty accessing outpatient services. Overall, the program demonstrated that a centralized, real-time intervention model can efficiently address inpatient delays and support better care progression.

Asset Subtitle

Ting-Jia Lorigiano

Meta Tag

Author List Andrew Hughes, Christina Staten, James Scheulen, Jason Conti, Kimia Ghobadi, Martin Copenhaver, Pete Travers, Rebecca Dezube, Ting-Jia Lorigiano

Category Innovations

Concept Inpatient Expeditor Program

Concept Hospital Flow

Concept Care Delay

Concept Command Center

Concept Email Workflow

Distinguished Non-Finalist

Presenter Organization Johns Hopkins Medicine

Presenting Author Ting-Jia Lorigiano

Track Value in Hospital Medicine

Keywords

inpatient expediter

hospital command center

care progression

throughput improvement

delay management

bed management

MRI requests

discharge barriers

same-day turnaround

clinical workflow

Inpatient Expeditor Program

Hospital Flow

Care Delay

Command Center

Email Workflow