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Recommended Citation
Leuck B, Gonzalez R, Peters S, Wright S, Witczak M. The Discharge Admission and Transfer (D.A.T) Nurse Program. Quality Improvement podium presentation at Transforming Practice: The Intersection of Technology and Nursing Excellence; Advocate Health Nursing Research and Professional Development Conference 2025; November 12, 2025; Virtual.
Presentation Notes
Quality Improvement podium presentation at Transforming Practice: The Intersection of Technology and Nursing Excellence; Advocate Health Nursing Research and Professional Development Conference 2025; November 12, 2025; Virtual.
Abstract
Background: Overcrowding and boarding in the emergency room is a national issue associated with delayed care, adverse events and increased mortality. This in turn impacts inpatient bed availability, capacity, and patient flow. Strategies to mitigate this include addressing barriers and facilitators to inpatient discharges. Baseline data (03-06/2024) showed on average 11% of discharges occurred before noon, 4.3 hours from order to discharge, 32% utilized the discharge pharmacy nurse navigator, and mean length of stay was 5.4 days.
Purpose: To pilot and evaluate the role of a discharge admission and transfer (DAT) nurse, whose primary goal is to improve discharge efficiency and alleviate emergency room boarding.
Literature Review: Evidence shows that delays in discharge can lead to increased length of stay and higher health care acquired infections, thereby increasing costs. Nurses play an integral role in the discharge process through education and coordination of care.
Description of setting and population: Four pilot medical/surgical/telemetry units at a quaternary medical center were selected due to patient acuity and throughput efficiency. A DAT nurse job description, workflow and checklist were created, with prioritization of discharge tasks. Four DAT nurses were recruited to provide discharge support during peak hours (0800-2030) Tuesday-Friday beginning July 2024, with one nurse per day.
Outcomes: Since implementation the DAT nurse has discharged 379 patients, with 70 of those before noon, and admitted 49 patients. Pilot unit data (07-10/2024) showed an increase to 13% of discharges occurred before noon and 36 % utilized the discharge pharmacy nurse navigator, and a decrease to 3.8 hours from order to discharge, while mean length of stay was consistent at 5.5 days.
Conclusions and Implications: Pilot data supports the DAT nurse improves discharge efficiency. The role will be expanded to additional units with opportunities to measure distal outcomes such as improved patient flow and readmissions.
Document Type
Oral/Podium Presentation
Publication Date
11-12-2025
The Discharge Admission and Transfer (D.A.T) Nurse Program
Background: Overcrowding and boarding in the emergency room is a national issue associated with delayed care, adverse events and increased mortality. This in turn impacts inpatient bed availability, capacity, and patient flow. Strategies to mitigate this include addressing barriers and facilitators to inpatient discharges. Baseline data (03-06/2024) showed on average 11% of discharges occurred before noon, 4.3 hours from order to discharge, 32% utilized the discharge pharmacy nurse navigator, and mean length of stay was 5.4 days.
Purpose: To pilot and evaluate the role of a discharge admission and transfer (DAT) nurse, whose primary goal is to improve discharge efficiency and alleviate emergency room boarding.
Literature Review: Evidence shows that delays in discharge can lead to increased length of stay and higher health care acquired infections, thereby increasing costs. Nurses play an integral role in the discharge process through education and coordination of care.
Description of setting and population: Four pilot medical/surgical/telemetry units at a quaternary medical center were selected due to patient acuity and throughput efficiency. A DAT nurse job description, workflow and checklist were created, with prioritization of discharge tasks. Four DAT nurses were recruited to provide discharge support during peak hours (0800-2030) Tuesday-Friday beginning July 2024, with one nurse per day.
Outcomes: Since implementation the DAT nurse has discharged 379 patients, with 70 of those before noon, and admitted 49 patients. Pilot unit data (07-10/2024) showed an increase to 13% of discharges occurred before noon and 36 % utilized the discharge pharmacy nurse navigator, and a decrease to 3.8 hours from order to discharge, while mean length of stay was consistent at 5.5 days.
Conclusions and Implications: Pilot data supports the DAT nurse improves discharge efficiency. The role will be expanded to additional units with opportunities to measure distal outcomes such as improved patient flow and readmissions.
Affiliations
St Luke's Medical Center