Discharging patients before noon, which is thought to reduce patient capacity bottlenecks, is both possible and sustainable, according to research published in the Journal of Hospital Medicine.
Researchers performed an intervention at two medical units that are part of an urban academic medical center. Before the intervention both units had DBN rates of less than 7 percent.
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The intervention consisted on a daily checklist, a website to enhance communication, afternoon rounds to identify DBN patients for the next day, daily feedback on DBN rates, rewards for success and real-time case review.
After eight months the DBN percentage increased to 38 percent, with the average discharge time between the units moving 1 hour and 31 minutes earlier in the day.
Researchers also recorded small decreases in length of stay and the 30-day readmission rate; more work is needed to understand the relationship between earlier discharge and outcome-of-care metrics, according to the study.
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