减少延误,改善流程:专门的出院协调员在医院出院计划中的重要性。

IF 1 Q3 MEDICINE, GENERAL & INTERNAL
Cureus Pub Date : 2025-06-12 eCollection Date: 2025-06-01 DOI:10.7759/cureus.85879
George Bechir, Angelina Bechir
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引用次数: 0

摘要

出院仍然是住院治疗中最脆弱的阶段之一,往往不是由于临床需要,而是由于成像、会诊、记录和运输等任务的分散协调而延误。这些瓶颈导致住院时间延长、急诊科拥挤、医疗保健费用增加以及患者满意度下降。在这篇文章中,我们研究了专门的出院协调员的关键作用——护士、执业护士或病例管理员——他们的任务是实时跟踪和解决当天的出院障碍。根据20项同行评议研究的结果,我们综合了证据,证明这种集中监督减少了LOS(通常为0.5至1天),提高了患者吞吐量,降低了再入院率,并加强了护理团队之间的沟通。我们探索了各种协调模型,从基于单位的辅助工具到电子健康记录(EHR)集成跟踪工具,并提供了现实世界的例子,其中时间上的轻微偏差,如延迟透析或计划外成像,导致可避免的住院天数,加强了对结构化和负责的出院管理的需求。出院协调员充当住院病人流量的操作“交通控制员”,确保及时、安全和协调的护理过渡。在当今紧张的医院系统中,这一角色对于维持安全、效率和能力至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Reducing Delays, Improving Flow: The Importance of a Dedicated Discharge Coordinator in Hospital Discharge Planning.

Hospital discharge remains one of the most vulnerable stages of inpatient care, frequently delayed not by clinical need but by fragmented coordination of tasks such as imaging, consults, documentation, and transportation. These bottlenecks contribute to prolonged length of stay (LOS), emergency department crowding, higher healthcare costs, and decreased patient satisfaction. In this article, we examine the critical role of a dedicated discharge coordinator - a nurse, nurse practitioner, or case manager - who is tasked solely with tracking and resolving same-day discharge barriers in real time. Drawing on findings from 20 peer-reviewed studies, we synthesize evidence demonstrating that such centralized oversight reduces LOS (often by 0.5 to 1 day), improves patient throughput, decreases readmission rates, and enhances communication between care teams. We explore various coordination models, ranging from unit-based facilitators to electronic health record (EHR)-integrated tracking tools, and present real-world examples where minor misalignments in timing, such as delayed dialysis or unscheduled imaging, led to avoidable hospital days, reinforcing the need for structured and accountable discharge management. The discharge coordinator acts as the operational "traffic controller" of inpatient flow, ensuring timely, safe, and coordinated transitions of care. In today's strained hospital systems, this role is essential for maintaining safety, efficiency, and capacity.

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