SHM Converge Scientific Abstract ePoster Gallery-Standardizing Interdisciplinary Rounds to Improve Hospital Efficiency and Reduce Length of Stay

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Executive leadership prioritized improving operational efficiency in 2023 after identifying that inpatient length of stay (LOS) exceeded local and national peers and that the health system faced overcrowding and capacity constraints. To address this, the team launched a standardized interdisciplinary rounds (IDR) model across inpatient medicine units with the goal of reducing LOS by 0.15 days, from 5.19 to 5.04 days.<br /><br />A multidisciplinary working group was formed, including frontline nurses, nursing and case management leaders, physicians, advanced practice providers, social work, pharmacy, and rehab services. The project focused on three main improvements: establishing clear IDR governance and facilitation, implementing a standard script, and improving identification/escalation of barriers to care progression.<br /><br />Key interventions included shifting IDR facilitation from nursing to case management, defining governance structure, regionalizing teams, increasing IDRs from 5 to 6 days per week, and requiring unit leaders to attend weekly IDRs to help resolve barriers and ensure accountability. A dynamic survey tool was created to capture and escalate recurring barriers to executive leadership, and observations were used to assess adherence to the script and process.<br /><br />Early results showed improved use of the standard script and facilitator presence, with better discussion of anticipated discharges. The project concluded that standardization and multidisciplinary engagement appear to support more efficient care progression and reduced LOS. Next steps include further regionalization, earlier barrier resolution, and development of a separate IDR process for long-stay patients.

Asset Subtitle

Erin C. O'Fallon

Meta Tag

Author List Erin C. O'Fallon, Johanna Baldassari, Luca Boi, Lynne M. Morrison, Miracia Charles

Category Innovations

Concept Interdisciplinary Rounds

Concept Hospital Efficiency

Concept Length of Stay

Concept Barrier Escalation

Concept Care Progression

Distinguished Non-Finalist

Presenter Organization Brigham and Womens Hospital

Presenting Author Erin C. O'Fallon

Track Quality Improvement

Keywords

operational efficiency

inpatient length of stay

interdisciplinary rounds

capacity constraints

multidisciplinary team

standardized script

care progression

barrier escalation

case management

hospital overcrowding

Interdisciplinary Rounds

Hospital Efficiency

Length of Stay

Barrier Escalation

Care Progression