Factors Associated With Delayed Discharge on General Medicine Service at an Academic Medical Center

被引:7
|
作者
Rohatgi, Nidhi [1 ,2 ]
Kane, Marlena [3 ,4 ,5 ,6 ]
Winget, Marcy [7 ]
Haji-Sheikhi, Farnoosh [8 ]
Ahuja, Neera [9 ,10 ,11 ]
机构
[1] Stanford Univ, Sch Med, Med, Stanford, CA 94305 USA
[2] Stanford Univ, Neurosurg, Sch Med, Stanford, CA 94305 USA
[3] Augmedix, San Francisco, CA USA
[4] Stanford Hlth Care, Performance Excellence & Med Serv, Stanford, CA USA
[5] Stanford Hlth Care, Value Stream Initiat, Stanford, CA USA
[6] Stanford Hlth Care, Strateg Operat Patient Care Serv, Stanford, CA USA
[7] Stanford Univ, Sch Med, Evaluat Sci Unit, Div Primary Care & Populat Hlth, Stanford, CA USA
[8] Stanford Univ, Sch Med, Dept Primary Care & Populat Hlth, Stanford, CA USA
[9] Stanford Univ, Sch Med, Med, Stanford, CA USA
[10] Stanford Univ, Sch Med, Div Hosp Med, Stanford, CA USA
[11] Stanford Univ, Sch Med, Internal Med Residency, Stanford, CA USA
关键词
estimated date of discharge; delayed discharge; barriers to discharge; CARE; COMMUNICATION;
D O I
10.1097/JHQ.0000000000000126
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Lack of collaboration between care teams and patients/families has been associated with delayed discharge from the hospital. In this study, we determine whether patients' awareness of the estimated date of discharge (EDD) was associated with a decrease in delayed discharge, and determine the factors associated with a delayed discharge. A total of 221 patients admitted to the General Medicine service between July and September 2014 were included in the study. Estimated date of discharge was identified within 36 hours of admission. The bedside nurse communicated this EDD to the patient/family. Patients were interviewed to identify whether they were aware of their EDD. Bedside nurses were interviewed to identify barriers to discharge. In our study, 49.8% of the patients had a delayed discharge. Patients who were aware of their EDD were less likely to have a delayed discharge (odds ratio [OR], 0.3 [95% confidence interval (CI). 0.1-0.6], p < .001). Patients who were discharged on Saturday or Sunday (OR, 4.8 [95% CI, 1.7-14.6], p < .001) and patients who were waiting for physicians' consult (OR, 4.5 [95% CI, 1.6-14.4], p = .007) were more likely to have a delayed discharge. Early identification of the EDD and communicating it with the care team and the patient/family. mobilizing resources for safe weekend discharges, and creating efficient process for consultations might decrease delayed discharges.
引用
收藏
页码:329 / 335
页数:7
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