Enhanced Discharge Bundles to Reduce Length of Stay.

Abstract

Introduction: Length of stay (LOS) is a critical metric for the efficient utilization of limited resources. A multidisciplinary task force in an academic hospital was created to optimize discharge planning with expanded resources to support a structured discharge process.

Methods: Between January and June 2023, multiple interventions were implemented in Hospital Medicine group. Inpatient LOS and other process, outcome, and balancing measures in the post-intervention period (July to December 2023) were compared to those in the pre-intervention period (July to December 2022). The patient demographics and clinical characteristics were adjusted for confounding factors.

Results: The mean inpatient LOS was 5.8 days post-intervention compared with 6.5 days in the pre-intervention cohort. After adjusting for potential confounding factors, we found a significant reduction in inpatient LOS by 0.56 days ( p = .019), while it did not affect all-cause readmissions or emergency department (ED) visits within 30 days after discharge.

Conclusions: Our multidisciplinary discharge bundle, appropriate case management support level and documentation enhancement seem to be a promising approach for coordinating discharge communication and subsequently reducing the LOS. Our plan is to scale this approach to other clinical areas, address identified care progression delays, and better manage the ED throughput to improve the care delivery system.