Reducing hospital admission delay times using a structured, systematic, multi-disciplinary approach

Abstract

A 6-month audit at the San Francisco VA Health Care System (October 2020 to March 2021) found a median admission delay of 207 min, higher than the national VA median of 146 min. A multi-disciplinary team found that factors contributing to this delay included unclear bed assignment processes, nursing handoff delays, and over-reliance on inpatient teams to initiate admission processes. After implementing three countermeasures—(1) bed assignment standardization, (2) nursing handoff improvement, and (3) skeletal admission orders—median admission delay decreased by 29.5%, from 207 to 145 min, over a 3-month period which has sustained since the changes were implemented.