SHM Converge Scientific Abstract ePoster Gallery-Reverse Rounding: An Innovative Way to Expedite Discharges by Noon

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This abstract describes “Reverse Rounding” (RR), a new inpatient workflow designed to improve discharge efficiency and help hospitals manage capacity constraints. The approach identifies patients likely to be discharged the next morning, then uses a multidisciplinary team—including providers, case managers, social work, physical therapy, and pharmacy—to prepare them in advance and prioritize them for early discharge.<br /><br />The pilot was conducted on a single hospital medicine unit at Presbyterian Medical Center from August 19 to September 16, 2024. Before the intervention, 50 discharge opportunities were reviewed. In the pre-intervention period, 28% of discharge orders were placed before 10 a.m., 24% were placed during the 10 a.m. hour, and only 36% of patients were physically off the unit by noon. Many discharge logistics were already completed the day before, including transport arrangements in 50% of cases and durable medical equipment needs in 94% of cases.<br /><br />After implementation of RR, discharge performance improved. The average proportion of discharge orders placed by 10 a.m. rose, and discharges before noon increased. The intervention was also associated with a reduction in length of stay, from an average of 8 days before the pilot to 7 days afterward, with the improvement sustained after the intervention period.<br /><br />Overall, the study suggests that Reverse Rounding is a practical, team-based strategy that can increase early discharge rates, reduce length of stay, and potentially improve hospital throughput and health equity.

Asset Subtitle

Asad Arastu

Meta Tag

Author List Asad Arastu, Helena Pittman, Judd D. Flesch, Lisa Triantos, Taylor Hedgeland, Zamia C. Diaz

Category Research

Concept Reverse Rounding

Concept Morning Discharge

Concept Hospital Capacity

Concept Discharge Planning

Concept Discharge Eligibility

Distinguished Non-Finalist

Presenter Organization University of Pennsylvania

Presenting Author Asad Arastu

Track Transitions of Care

Keywords

Reverse Rounding

inpatient workflow

discharge efficiency

hospital capacity

early discharge

multidisciplinary team

length of stay

hospital throughput

case management

health equity

Reverse Rounding

Morning Discharge

Hospital Capacity

Discharge Planning

Discharge Eligibility