SHM Converge Scientific Abstract ePoster Gallery-Teamwork in Action: A Pragmatic Trial of Clinical Assistant-Facilitated Hospital Discharges

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This pragmatic prospective study examined whether a clinical assistant could improve hospital discharge workflow by helping hospital teams complete discharge-related tasks. The intervention was tested from March 18 to April 10, 2025, across four direct care teams and four teaching teams, with comparison control teams in both settings.<br /><br />The clinical assistant proactively identified patients likely to be discharged and helped coordinate anticipatory discharge planning, expedited workup tasks, discharge logistics, and outpatient follow-up. The main goal was to see whether this support improved discharge timing.<br /><br />The study found that clinical assistant–facilitated discharge support significantly increased early discharge order completion among direct care hospitalists. Specifically, 16.3% of intervention discharges had orders signed by 10 a.m. compared with 6.3% in controls, a 10% absolute increase (p = 0.02). Physician satisfaction with the discharge process also improved substantially, rising from 18% to 52% in the intervention arm.<br /><br />However, the intervention did not significantly change broader throughput outcomes, including discharge by noon, length of stay, or median time of discharge. This suggests that while physician-facing discharge support can help providers place orders earlier and improve their experience, the actual discharge time is influenced by multiple additional factors beyond physician order timing.<br /><br />The authors conclude that clinical assistant support may be valuable for improving physician satisfaction and potentially reducing burnout, even if immediate hospital flow metrics do not change. They suggest that stronger effects on throughput may require a longer implementation period and better integration with multidisciplinary discharge processes.

Asset Subtitle

Brandon S. Scott

Meta Tag

Author List Adeena Khan, Brandon S. Scott, Colin Hubbard, Connie Li, Ethel Wu, Guinn Ellen Dunn, Margaret C. Fang, Priyanka Sapra, Sandra Oreper, Sarah Apgar

Category Research

Concept Hospital Discharge Workflow

Concept Clinical Assistant

Concept Length of Stay

Concept Discharge Planning

Concept Care Coordination

Distinguished Non-Finalist

Presenter Organization University of California San Francisco

Presenting Author Brandon S. Scott

Track Value in Hospital Medicine

Keywords

clinical assistant

hospital discharge workflow

discharge planning

early discharge orders

physician satisfaction

hospital throughput

length of stay

discharge logistics

outpatient follow-up

prospective study

Hospital Discharge Workflow

Clinical Assistant

Length of Stay

Discharge Planning

Care Coordination