SHM Converge Scientific Abstract ePoster Gallery-Improving Monday Discharges by Adjusting Hospitalist's Start Day

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This project evaluated whether changing the hospitalist 7-day rotation start day from Monday to Tuesday would improve inpatient discharge flow. The team hypothesized that Tuesday start days would increase Monday discharges by improving attending physician continuity during Monday interdisciplinary rounds and help reduce delays caused by weekend throughput slowdown.<br /><br />Using inpatient discharge data from NYU Langone Health, the study compared outcomes from 7 months before the change with 17 months after the change. The main outcomes were the percentage of discharges on Monday and Tuesday and the observed-to-expected length of stay (O:E LOS). Two-sample t-tests and chi-square tests were used for analysis.<br /><br />After the schedule change on April 18, 2022, Monday discharges increased from 12.5% to 14.3% (1.8% absolute increase, 14% relative increase; p=0.0016). Tuesday discharges decreased from 17.4% to 14.8% (2.6% absolute decrease, 15% relative decrease; p=0.001). O:E LOS also improved, dropping from 0.89 to 0.80, a 9% absolute reduction (p=0.001).<br /><br />The authors concluded that shifting the hospitalist start day from Monday to Tuesday was associated with significantly more Monday discharges, fewer Tuesday discharges, and shorter-than-expected length of stay. They noted that COVID-19 and other confounding factors may have influenced results, so the findings do not prove direct causation. Overall, the intervention appeared operationally beneficial without harming hospitalist satisfaction.

Asset Subtitle

Larry Nguyen

Meta Tag

Author List Adriana Quinones-Camacho, Benjamin Verplanke, Katherine Hochman, Kevin Eaton, Larry Nguyen, Lauren Messing, Vincent Li

Category Research

Concept Hospitalist Service Schedule

Concept Hospital Discharge

Concept Monday

Concept Length of Stay

Concept Tuesday Discharge

Distinguished Non-Finalist

Presenter Organization NYU Grossman School of Medicine

Presenting Author Larry Nguyen

Track Quality Improvement

Keywords

hospitalist rotation

Tuesday start day

Monday discharges

inpatient discharge flow

length of stay

interdisciplinary rounds

attending physician continuity

weekend throughput

NYU Langone Health

operational efficiency

Hospitalist Service Schedule

Hospital Discharge

Monday

Length of Stay

Tuesday Discharge