SHM Converge Scientific Abstract ePoster Gallery-Leveraging Technology - A Virtual Twist on Care Coordination Rounds

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This project describes a secure chat-based virtual care coordination round (CCR) model implemented on a medicine unit in a 700-bed safety-net hospital to improve discharge efficiency. In April 2022, patients from two hospital medicine teams were localized to one unit, enabling the Patient Care Coordinator (PCC) to initiate brief multidisciplinary rounds using Epic secure chat. The PCC created separate chats with physicians and advanced practice providers for each team, then added case managers, social workers, and charge nurses. During these less-than-10-minute rounds, the team discussed discharge readiness and barriers, and the PCC escalated needs to other services such as physical therapy or respiratory therapy when needed.<br /><br />The goal was to improve early discharge metrics, especially discharge orders by 10 a.m. and actual discharges by noon, which can improve ED throughput and reduce boarding. Before implementation (April 2021–March 2022), 29% of patients had discharge orders by 10 a.m. and 31.3% were discharged by noon. After implementation (April–June 2022), these rates increased to 50% and 44.3%, respectively. Both improvements were statistically significant (p=0.00001 for discharge orders by 10 a.m.; p=0.0005 for discharges by noon).<br /><br />Provider feedback was strongly positive. In a survey of hospitalists on the pilot unit, all respondents agreed or strongly agreed that virtual CCRs should continue, helped escalate discharge barriers, and reduced time needed to discharge patients. Nursing and social work leaders also reported better communication, more team participation, and improved patient-centered care.<br /><br />The authors conclude that secure chat-based virtual CCRs are brief, structured, and effective for improving early discharges. Following the pilot, this model was adopted as the standard morning CCR process for all eight direct care hospital medicine teams.

Asset Subtitle

Gregory Bowling

Meta Tag

Author List Ankur Segon, Gregory Bowling, Ronald Estrella, Saket Kottewar

Category Research

Concept Virtual Care Coordination Rounds

Concept Epic Secure Chat

Concept Discharge Planning

Concept Discharge Readiness

Concept Discharge Barrier

Distinguished Non-Finalist

Presenter Organization UT Health San Antonio

Presenting Author Gregory Bowling

Track Quality Improvement

Keywords

secure chat

virtual care coordination rounds

discharge efficiency

hospital medicine

Epic secure chat

multidisciplinary rounds

patient care coordinator

early discharge metrics

discharge barriers

safety-net hospital

Virtual Care Coordination Rounds

Epic Secure Chat

Discharge Planning

Discharge Readiness

Discharge Barrier