SHM Converge Scientific Abstract ePoster Gallery-Why Not Today? Transforming Care Progression With a System-Wide Huddle

Pdf Summary

This project evaluated a daily, system-wide “Escalation Huddle” designed to improve patient progression and reduce excess hospital days across two acute care hospitals in Albany, New York. The hospitals were concerned that interdisciplinary rounds alone were not resolving all discharge barriers and that provider practice variation was contributing to a high observed-to-expected (O:E) length-of-stay ratio, which had reached 1.34.<br /><br />The intervention added a 25-minute virtual huddle each day after unit-based interdisciplinary rounds. During the huddle, nurse managers from each unit presented patients expected to discharge the next day and asked, “Why not today?” They also raised any system-level issues delaying care. A hospitalist leader facilitated the huddle and used the Epic dashboard to review patient status, identify discharge delays, and provide guidance when discharge timing did not match accepted clinical standards. Ancillary departments such as therapy, radiology, procedural areas, home nursing, and hospice participated and reprioritized work to support same-day discharges.<br /><br />The huddle improved team understanding of discharge plans and standards, exposed variation in provider practice, promoted more consistent care through protocol reinforcement, and shifted the culture from thinking in calendar days to thinking in hours. It also empowered nurse managers to raise concerns constructively and enabled rapid problem-solving.<br /><br />After implementation, the health system’s average O:E ratio for length of stay improved from 1.25 in the year before the intervention to 1.18 in the year after, with less variability. Overall, the daily Escalation Huddle successfully improved care coordination, reduced practice variation, and resolved barriers to patient progression in real time.

Asset Subtitle

Thea Dalfino

Meta Tag

Author List Christopher Jordan, Thea Dalfino

Category Innovations

Concept Escalation Huddle

Concept Interdisciplinary Rounds

Concept Care Coordination

Concept Discharge Progression

Concept Length of Stay

Distinguished Non-Finalist

Presenter Organization Ellis Hospital

Presenting Author Thea Dalfino

Track Communication

Keywords

Escalation Huddle

patient progression

length of stay

discharge barriers

interdisciplinary rounds

hospital efficiency

care coordination

practice variation

hospitalist leader

Epic dashboard

Escalation Huddle

Interdisciplinary Rounds

Care Coordination

Discharge Progression

Length of Stay