SHM Converge Scientific Abstract ePoster Gallery-From Bottlenecks to Breakthroughs: How Timely Discharge Initiatives at a Cancer Institution Positively Impacted Inpatient Flow Effectiveness Within a Complex Medical Oncology Population

From Bottlenecks to Breakthroughs: How Timely Discharge Initiatives at a Cancer Institution Positively Impacted Inpatient Flow Effectiveness Within a Complex Medical Oncology Population

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This report describes a multidisciplinary timely discharge initiative at MD Anderson Cancer Center aimed at improving inpatient flow in a complex medical oncology population. Rising inpatient demand, chronic disease burden, and hospital capacity pressures created urgency to reduce discharge delays and boarding times.<br /><br />Using a Plan-Do-Study-Act approach, the team developed a novel DiCE model (Discharge-barrier identification, Communication, Escalation) to proactively identify discharge barriers, improve closed-loop communication, and escalate issues early. The model was piloted on medical oncology units in July 2024. Key goals were to increase discharge order entry before 9 AM, discharges by noon, and accuracy of estimated discharge dates (EDD) one day before discharge, each to 50%.<br /><br />Baseline FY2023 performance was low: 7.78% of discharge orders were placed before 9 AM, 8.21% of patients were discharged before noon, and EDD accuracy was 44.77%. After implementation, major improvements were achieved. By August 2025, discharge orders before 9 AM increased to 53.87%, discharges by noon rose to 55.23%, and EDD accuracy improved to 54.12%. Two specific barrier categories also improved significantly: consultant delays decreased from 15.3% to 11.7% (p=0.013), and medication delays fell from 5.8% to 3.0% (p=0.00064).<br /><br />The authors conclude that a structured, proactive discharge program can substantially improve discharge efficiency, inpatient throughput, and hospital compression. The initiative also reduced emergency department boarding times from 5–6 hours to 2–3 hours, supporting faster treatment access and better multidisciplinary coordination.

Asset Subtitle

Marina George

Meta Tag

Author List Altrivice Revis, Amin Alousi, Christopher Flowers, Corey Russell, David Rubio, Delmy Vesho, Jeffrey Bruno, Jose Rivera, Josiah Halm, Judith Odityo, Kaycee Wilson, Kim Slusser, Kodwo Bosomefi Dickson, Marina George, Mayoora Muthu, Mercedes Geaslin, Mi

Category Innovations

Concept Discharge Planning

Concept Inpatient Flow

Concept Capacity Management

Concept PDSA Cycle

Concept Discharge Barrier

Distinguished Non-Finalist

Presenter Organization The University of Texas MD Anderson Cancer Center

Presenting Author Marina George

Track Quality Improvement

Keywords

timely discharge

inpatient flow

medical oncology

DiCE model

discharge barriers

closed-loop communication

estimated discharge date

Plan-Do-Study-Act

hospital throughput

emergency department boarding

Discharge Planning

Inpatient Flow

Capacity Management

PDSA Cycle

Discharge Barrier