Medicine and Health Sciences Commons^™

Postoperative Discharge Destination Impacts 30-Day Outcomes: A National Surgical Quality Improvement Program Multi-Specialty Surgical Cohort Analysis, Carlos Riveros, Sanjana Ranganathan, Yash Shah, Emily Huang, Jiaqiong Xu, Michael Geng, Zachary Melchiode, Siqi Hu, Brian Miles, Nestor Esnaola, Dharam Kaushik, Angela Jerath, Christopher Wallis, Raj Satkunasivam

Student Papers, Posters & Projects

Surgical patients can be discharged to a variety of facilities which vary widely in intensity of care. Postoperative readmissions have been found to be more strongly associated with post-discharge events than pre-discharge complications, indicating the importance of discharge destination. We sought to evaluate the association between discharge destination and 30-day outcomes. A retrospective cohort study was conducted using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database. Patients were dichotomized based on discharge destination: home versus non-home. The main outcome of interest was 30-day unplanned readmission. The secondary outcomes included post-discharge pulmonary, infectious, thromboembolic, and bleeding complications, …

Improving The Workflow And Partnership Between Registration And Clinical Staff In An Outpatient Urgent Care Center, Melissa Fairfield, Bailey Eells, Faye Collins, Joyce Cornish, Stephen Tyzik, Joy Moody, Wendy Osgood, Suneela Nayak, Ruth Hanselman, Amy Sparks

Operations Transformation

An outpatient urgent care unit was experiencing challenges in balancing the need to register patients and delivering care in the timeliest manner as possible. Upon examination, it was found that delays were being experienced in patient triage and discharge that resulted in low patient satisfaction scores.

A team of providers was established to review all process steps and a quality improvement project was created to attain a goal of 100% of the time discharge would not be delayed due to incomplete registration.

Baseline metrics demonstrated current numbers of delayed discharges, median time from door to triage as well as door …

Improving Patient Flow By Increasing Early Discharges On A Mother & Baby Unit, Faye Weir, Joy Moody, Kathleen Cyr, Cathy Palleschi, Stephen Tyzik, Joseph East, Heidi Morin, Suneela Nayak, Ruth Hanselman, Amy Sparks

Operations Transformation

Discharging patients early in the day has many advantages amongst which is increased bed availability. However, the experience in a large academic tertiary medical center demonstrated that most discharges occurred early to mid afternoon. A care team on a mother /baby unit established a quality improvement project to increase the number of discharges by 11AM and streamline key discharge planning activities.

A root cause analysis identified multiple barriers to attaining he established goals. To address these barriers, a multi prong approach was instituted to include a discharge education KPI for all unit staff.

Data collection post countermeasure implementation demonstrated some …

Strategies To Increase Early Discharges To Reduce Avoidable Patient Days And Improve Patient Flow, Cathy Palleschi, Cecilia Inman, Erica Weightman, James B. Powers, Stephen Tyzik, Joy Moody, Mark Parker, Suneela Nayak, Ruth Hanselman, Amy Sparks

Operations Transformation

CREATING ALGORITHMS TO INCREASE THE NUMBERS OF HOSPITAL MORNING DISCHARGES RESULTING IN IMPROVED PATIENT FLOW

Discharging a percentage of patients early in the day helps to improve patient flow. This results in a reduction of Emergency Department congestion as well as peaks in patient numbers in the early to late afternoon on patient care units.

A cardiac unit in an academic tertiary medical center created a goal to increase the number of their discharges by 11 AM and to streamline key discharge planning activities. A root cause analysis was initiated and after identifying several barriers, two KPIs were developed using …

Benchmarking Hospital Performance Using Health Analytics, Viju Raghupathi, Wullianallur Raghupathi

Publications and Research

Background: The objective of this study is to investigate hospital performance using an emerging analytics approach. Given that hospital care accounts for a large segment of healthcare spending, it is essential that hospital performance be measured over time to determine whether and where there is room for improvement in some of its critical success factors, and if there are savings to be found.

Methods: Employing indicators such as hospital cost, in-hospital death rate, length of hospital stay, and the number of discharges from the hospital, we look at the trends for these indicators over a 10-year period. Data was extracted …

Using Computer Simulation To Study Hospital Admission And Discharge Processes, Edwin S. Kim

Masters Theses 1911 - February 2014

Hospitals around the country are struggling to provide timely access to inpatient beds. We use discrete event simulation to study the inpatient admission and discharge processes in US hospitals. Demand for inpatient beds comes from two sources: the Emergency Department (ED) and elective surgeries (NonED). Bed request and discharge rates vary from hour to hour; furthermore, weekday demand is different from weekend demand. We use empirically collected data from national and local (Massachusetts) sources on different-sized community and referral hospitals, demand rates for ED and NonED patients, patient length of stay (LOS), and bed turnover times to calibrate our discrete …