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Addressing Discharge Delays as Opportunity for Healthcare Efficiency Gains and Safety Gains
Patient Safety

Addressing Discharge Delays as Opportunity for Healthcare Efficiency Gains and Safety Gains

This position statement provides real time information to support policy decisions. This excerpt is from “Rethinking Patient Discharge: A Low-cost Opportunity for Healthcare Efficiency Gains” (Caligiuri C, Penzo-Mendez A, Mueller B. 2021 Dec). 

Patient discharge delays are a source of healthcare inefficiencies

Frustration over hospital discharge delays and the bottlenecks they create are a familiar experience to patients and staff. Hours are wasted while inpatients wait to leave, staff wait for free beds, and new patients wait for initial evaluation in overcrowded emergency departments (EDs). In addition to causing revenue losses, discharge delays may put patients at risk. Anxiety, depression, physical decline from immobility, and risks of infections, bedsores, and falls all increase the longer the patient stays in the hospital, and clinical studies show higher morbidity and mortality in patients whose discharge is delayed. ED overcrowding can lead to serious adverse events from delayed critical care and medical errors, and some patients may become so frustrated that they choose to leave before being seen.

While discharge delays are only one factor contributing to overcrowding, they are also an overlooked one. Specific evidence-based guidance to address discharge delays is sparse, with current evidence focused on department- specific patient flow as opposed to hospital-wide strategies. Inherent limitations in conducting unbiased definitive research restricts available evidence; however, successful improvement efforts have been documented in the clinical literature and show that large efficiency gains can be achieved with relatively modest investments. The evidence also highlights the need for more research and support for care provider efforts. ECRI believes addressing discharge delays is a major opportunity for efficiency and safety gains and encourages concerted effort by healthcare stakeholders to help optimize discharge processes.

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