Improving Discharge Rates to Home With the Help of Mobility Technicians: A Step in the Right Direction

Patel, Swapnil V; Imburgio, Steven; Johal, Anmol S; Ramirez, Claudia; DiSandro, Kristin; Mathur, Divya; Walch, Brian; Buccellato, Vito; Hossain, Mohammad A; Asif, Arif

doi:10.7759/cureus.48298

Cited by 1 publication

(2 citation statements)

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“…Moreover, reducing the length of hospital stays enables healthcare systems to enhance bed turnover rates and alleviate strain on critical resources, including nursing staff [16]. Previous investigations at our institution, focusing on daily mobility to improve LOS rates, also demonstrated statistically significant reductions in patient stays [12]. These shortened stays result in substantial healthcare cost savings for both patients and healthcare systems.…”

Section: Discussionmentioning

confidence: 72%

“…The overarching goal of this quality improvement project was to assess the impact of a multidisciplinary approach on discharge rate to home within a single institution. This was accomplished with daily mobilization, physician education, patient education, and electronic medical record (EMR) initiatives constituting key components of a comprehensive approach aimed at facilitating safe discharges to home [12][13][14].…”

Section: Introductionmentioning

confidence: 99%

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Improving Patient Outcomes Using Measures to Increase Discharge Rates to Home

Patel,

Arcidiacono,

Austin

et al. 2024

Cureus

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BackgroundPost-acute care (PAC) centers are facilities used for recuperation, rehabilitation, and symptom management in an effort to improve the long-term outcomes of patients. PAC centers include skilled nursing facilities, inpatient rehabilitation facilities, and long-term care hospitals. In the 1990s, Medicare payment reforms significantly increased the discharge rates to PAC centers and subsequently increased the length of stay (LOS) among these patient populations. Over the last several years, there have been national initiatives and multidisciplinary approaches to improve safe discharge rates to home. Multiple studies have shown that patients who are discharged to home have decreased rates of 30-day readmissions, reduced short-term mortality, and an improvement in their activities of daily living. ObjectivesThis study aimed to investigate how multidisciplinary approaches could improve a single institution's discharge rates to home. In doing so, we aim to lower hospital readmission rates, hospital length of stay, morbidity and mortality rates, and healthcare-associated costs. MethodsA retrospective single-institution cohort study was implemented at Jersey Shore University Medical Center (JSUMC). Data from January 2015 to December 2019 served as the control period, compared to the intervention period from January 2020 to January 2024. Patients were either admitted to JSUMC teaching faculty, hospitalists, or "others," which is composed of various medical and surgical subspecialists. Interventions performed to improve home discharge rates can be categorized into the following: physician education, patient education, electronic medical record (EMR) initiatives, accountability, and daily mobility initiatives. All interventions were performed equally across the three patient populations. The primary endpoint was the proportion of patients discharged to home. ResultsThere were 190,699 patients, divided into a pre-intervention group comprising 98,885 individuals and a post-intervention group comprising 91,814 patients. Within the pre-intervention group, the faculty attended to 8,495 patients, hospitalists cared for 39,145 patients, and others managed 51,245 patients. In the post-intervention period, the faculty oversaw 8,014 patients, hospitalists attended to 35,094 patients, and others were responsible for 48,706 patients. After implementing a series of multidisciplinary interventions, there was a significant increase in the proportion of patients discharged home, rising from 74.9% to 80.2% across the entire patient population. Specifically, patients under the care of the faculty experienced a more substantial improvement, with a discharge rate increasing from 73.6% to 84.4%. Similarly, the hospitalists exhibited a rise from 69.4% to 74.3%, and the others demonstrated an increase from 79.3% to 83.7%. All observed changes yielded a p-value < 0.001. ConclusionsBy deploying a multifaceted strategy that emphasized physician education, patient education, EMR initiatives, accountability measures, and daily mobility, ther...

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Section: Discussionmentioning

confidence: 72%

Section: Introductionmentioning

confidence: 99%