SHM Converge Scientific Abstract ePoster Gallery-Optimizing Hospital Throughput Efficiency Using a "Prepare for Discharge" Order

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Northwell Health describes an initiative to improve hospital throughput and discharge efficiency using a simple electronic medical record order called “Prepare for Discharge.” At their 800-bed quaternary care hospital, unit physician leaders place this order during interdisciplinary rounds when a patient is expected to be medically ready for discharge within 1–2 days. The order helps communicate discharge readiness across teams, reduce barriers, and align planning among physicians, nurses, pharmacy, therapy, and case management.<br /><br />To strengthen adoption, the order was linked to the testing escalation pathway, encouraging providers to use it. Once compliance reached 40%, it was used to trigger automated discharge workflows, including faster imaging and therapy, medication education, follow-up appointment scheduling, consultant recommendations, and nursing scripting for patients and families.<br /><br />The program has grown steadily, with about 70% of patients now receiving the order roughly 44 hours before discharge. A dashboard tracks provider-level use and throughput metrics, enabling targeted feedback and education. Starting in 2023, attendings also receive monthly automated emails comparing their use of the order to peers and highlighting its benefits.<br /><br />After changes launched in October 2022, the hospital saw significant reductions in excess days for 11 medicine units, excluding COVID-19 cases. Providers reported that the process improved efficiency and communication, and the team expects continued gains in hospital throughput and patient satisfaction.

Asset Subtitle

Yakov Kandov

Meta Tag

Author List Charles L. Kast, Esther Ahn, Jonathan Silver, Marybeth Attanasio, Maude Martocci, Meghan Scanlon, Yakov Kandov

Category Innovations

Concept Prepare for Discharge Order

Concept Discharge Readiness

Concept Interdisciplinary Rounds

Concept Early Discharge Planning

Concept Shared Electronic Medical Record Results Pool

Distinguished Non-Finalist

Presenter Organization North Shore University Hospital, Northwell Health

Presenting Author Yakov Kandov

Track Technology in Hospital Medicine

Keywords

hospital throughput

discharge efficiency

electronic medical record

Prepare for Discharge

interdisciplinary rounds

discharge readiness

automated workflows

provider compliance

patient discharge

Northwell Health

Prepare for Discharge Order

Discharge Readiness

Interdisciplinary Rounds

Early Discharge Planning

Shared Electronic Medical Record Results Pool