For the study, researchers created a ‘value team’ at a 627-bed, tertiary care academic medical center. They implemented a quality improvement project using Lean Six Sigma methodology.
The project involved the team defining the problems around timeliness of discharge and then going through the steps in the Define, Measure, Analyze, Improve, Control framework. They then implemented interventions based on an in-depth analysis of barriers to the discharge process. The interventions included geographic cohorts of internal medicine physicians on specific hospital units and multidisciplinary huddles one day before anticipated discharge.
The study shows the percentage of discharge orders released by 10:00 a.m. increased by 21.3 points postintervention, and the percentage of patients discharged by noon increased by 7.5 points. There were no significant changes in the 30-day readmission rate or length of stay.
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