SHM Converge Scientific Abstract ePoster Gallery-It's About Time: Systematic Efforts to Discharge Patients by 11:00 Am

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This quality improvement project at a 40,000-discharge/year academic tertiary care center aimed to reduce afternoon discharge bottlenecks by increasing the number of patients discharged by 11:00 a.m. The team hypothesized that shifting more discharges to the morning would improve hospital efficiency and throughput without worsening length of stay (LOS) or 30-day readmission rates.<br /><br />The goal was to raise the percentage of patients discharged by 11:00 a.m. (DCB11) from 8% to 25% within one year while maintaining stable LOS and readmission performance. Interventions were implemented in two cycles. In Cycle 1, teams identified two patients per unit who could safely be discharged by 11:00 a.m., introduced care progression huddles over six months using the Qventus Pathfinder discharge planning platform, completed medication reconciliation one day before discharge, and targeted discharge orders by 9:00 a.m. Cycle 2 focused on unit-level deep dives to spread standard work and remove unit-specific barriers.<br /><br />Results showed improvement in morning discharges. The average percentage of patients discharged by 11:00 a.m. increased from a baseline of 8.8% to 13.8% after Cycle 1 and to 15.9% after Cycle 2. LOS remained stable at 1.46 compared with a baseline of 1.54, and 30-day readmission rates did not meaningfully worsen, moving from 12.32% at baseline to 12.98% after Cycle 1 and 12.09% after Cycle 2.<br /><br />Overall, the project demonstrated that systematic discharge planning and workflow redesign can increase early-day discharges and support hospital efficiency during periods of high demand, with no negative impact on LOS or readmissions.

Asset Subtitle

John D. Keilty

Meta Tag

Author List John D. Keilty, Jordan Marmet, Rodney Haas, Sameer Gupta

Category Research

Concept Hospital Flow

Concept Discharge timing

Concept Patient Discharge

Concept Morning Discharge

Concept Readmission Rate

Distinguished Non-Finalist

Presenter Organization University of Minnesota Medical School

Presenting Author John D. Keilty

Track Quality Improvement

Keywords

quality improvement

morning discharge

hospital throughput

discharge planning

length of stay

readmission rates

workflow redesign

care progression huddles

medication reconciliation

academic medical center

Hospital Flow

Discharge timing

Patient Discharge

Morning Discharge

Readmission Rate