SHM Converge Scientific Abstract ePoster Gallery-Implementation of an Escalation Pathway to Reduce Avoidable Hospital Days

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This study examined whether a discharge barrier escalation pathway could reduce avoidable hospital days at an academic-affiliated community hospital. Longer hospital stays can worsen patient flow, contribute to overcrowding and ED boarding, delay transfers and elective procedures, and increase risks such as infections, pressure ulcers, and deconditioning.  <br /><br />The hospital implemented a structured escalation pathway on July 1, 2024 to improve communication and allow care team members to directly escalate discharge barriers to leadership. Common barriers addressed through the pathway included discharge site coordination, outpatient care coordination, procedural delays, and imaging delays. The team tracked escalations and compared avoidable hospital days before and after implementation.  <br /><br />In the four months before the pathway went live (March 1–June 30, 2024), there were 1,042 avoidable hospital days, averaging 260 per month. In the four months after implementation (July 1–October 31, 2024), avoidable hospital days fell to 446 total, or 111.5 per month. This was a 42.8% reduction.  <br /><br />The authors conclude that a streamlined escalation process for discharge barriers can effectively reduce avoidable hospital days. They suggest this model could be adopted by other hospitals and note that future research should assess its impact on additional quality-of-care outcomes.

Asset Subtitle

Christina Lin

Meta Tag

Author List Christina Lin, Gemma Chan, Jeff Ketchersid, Jingkun (Ginger) Yang, Lisa Shieh, Maria Victoria T. Paz

Category Research

Concept Hospital Length of Stay

Concept Avoidable Hospital Days

Concept Discharge Barrier Escalation Pathway

Concept Discharge Barrier

Concept Discharge Coordination

Distinguished Non-Finalist

Presenter Organization Stanford Tri-Valley

Presenting Author Christina Lin

Track Quality Improvement

Keywords

avoidable hospital days

discharge barriers

escalation pathway

hospital length of stay

patient flow

care coordination

hospital overcrowding

ED boarding

discharge planning

quality improvement

Hospital Length of Stay

Avoidable Hospital Days

Discharge Barrier Escalation Pathway

Discharge Barrier

Discharge Coordination