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Recommended Citation
Sobeck J, D'Louhy K, Soltis A, Connell C. Improving Throughput and Discharge-to-Door Times: Achieving Optimal Patient Discharge in Under Two Hours. Quality Improvement poster presented 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 poster presented 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: Prolonged discharge times has an impact on both the patient and the healthcare system. As hospital census increases, more patients are being boarded in the emergency department. This results in delayed bed placement, delayed throughput, and delayed discharges by nursing departments receiving emergency department patients.
Local Problem: Increased census, bed capacity constraints, delay in order placement, and poor communication between interdisciplinary teams has led to longer average discharge to door times. These increased discharge to door times have led to an increase in the overall hospital census and increased wait times for beds in the emergency department.
Method: These issues resulted in multiple methods of improving discharge times being implemented. These methods include implementation of a throughput nurse role to assist with admissions while the patient is in the emergency department, discharge barriers assessments, utilization of the discharge lounge, workflow modifications, interdisciplinary collaboration, and enhanced care coordination rounds to assess patient discharge needs. Data was collected on both observation and inpatients on the Short Stay unit.
Results: With the implementation of the methods above, discharge to door times improved overall. Discharges under two hours increased to 79% in 2024, which improved from 51% in 2021, 57% in 2022 and 61% in 2023. Average discharge to door times for the Short Stay decreased, with an average time of 1.15 hours in 2024. This improved from 1.95 hours in 2021, 1.72 hours in 2022 and 1.6 hours in 2023.
Implications for Nursing Practice: Application and utilization of these methods can be implemented on both observation and inpatient units. Nurses in observation and inpatient units can support throughput by starting the admission process in the ED. Discharge barriers assessments on admission can support nursing improve discharge to door times.
Document Type
Poster
Publication Date
11-12-2025
Improving Throughput and Discharge-to-Door Times: Achieving Optimal Patient Discharge in Under Two Hours
Background: Prolonged discharge times has an impact on both the patient and the healthcare system. As hospital census increases, more patients are being boarded in the emergency department. This results in delayed bed placement, delayed throughput, and delayed discharges by nursing departments receiving emergency department patients.
Local Problem: Increased census, bed capacity constraints, delay in order placement, and poor communication between interdisciplinary teams has led to longer average discharge to door times. These increased discharge to door times have led to an increase in the overall hospital census and increased wait times for beds in the emergency department.
Method: These issues resulted in multiple methods of improving discharge times being implemented. These methods include implementation of a throughput nurse role to assist with admissions while the patient is in the emergency department, discharge barriers assessments, utilization of the discharge lounge, workflow modifications, interdisciplinary collaboration, and enhanced care coordination rounds to assess patient discharge needs. Data was collected on both observation and inpatients on the Short Stay unit.
Results: With the implementation of the methods above, discharge to door times improved overall. Discharges under two hours increased to 79% in 2024, which improved from 51% in 2021, 57% in 2022 and 61% in 2023. Average discharge to door times for the Short Stay decreased, with an average time of 1.15 hours in 2024. This improved from 1.95 hours in 2021, 1.72 hours in 2022 and 1.6 hours in 2023.
Implications for Nursing Practice: Application and utilization of these methods can be implemented on both observation and inpatient units. Nurses in observation and inpatient units can support throughput by starting the admission process in the ED. Discharge barriers assessments on admission can support nursing improve discharge to door times.
Affiliations
Christ Medical Center