SHM Converge Scientific Abstract ePoster Gallery-What's the Delay? Innovative Digital Tools to Track Discharge Delays

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Northwell Health developed “Nora,” a Microsoft Teams–based, automated tool that pulls patient summary information from the electronic health record to support interdisciplinary rounds and track discharge delays. Built with the help of the organization’s technology innovations center, Nora was designed to improve communication during IDRs and standardize the rounding process across multiple sites and disciplines.<br /><br />The project’s primary goal was to expand Nora’s use to better understand common barriers to planned discharge. A secondary goal was to compare how these barriers change over time across different service lines. Teams use Nora to record an expected discharge date; if the date changes, users enter the reason from a predefined list. The tool was first established as the standard IDR rounding platform at the tertiary academic institution and was later expanded to include both medicine and surgical co-management specialties.<br /><br />Since July 2023, the team has collected data from medicine and co-managed surgical services, analyzing not only the most common causes of delay but also the number of excess hospital days associated with each delay. Early findings show that the largest contributors to excess length of stay are patient requests to remain hospitalized longer and delays in coordinating post-acute care services.<br /><br />Next steps include running PDSA cycles focused on the top barriers, adding more machine learning to predict delays before they occur, and extending Nora to other departments such as radiology and consulting services. The project aims to use digital tools to improve discharge planning, reduce avoidable delays, and enhance patient flow.

Asset Subtitle

Andrew Price

Meta Tag

Author List Andrew Price, Semie Kang

Category Innovations

Concept Hospital Discharge

Concept Discharge Delay

Concept Discharge Barrier

Concept Length of Stay

Concept Nora Digital Tool

Distinguished Finalist

Presenter Organization Northwell Health - Lenox Hill Hospital

Presenting Author Andrew Price

Track Technology in Hospital Medicine

Keywords

Northwell Health

Nora

Microsoft Teams

electronic health record

interdisciplinary rounds

discharge delays

patient flow

length of stay

post-acute care

machine learning

Hospital Discharge

Discharge Delay

Discharge Barrier

Length of Stay

Nora Digital Tool