Unlocking success: Multidisciplinary rounds for effective discharge planning.

Abstract

341 Background: Multidisciplinary rounds (MDR) streamline collaboration among healthcare professionals across various disciplines to devise patient progress and post-hospitalization transition plans. In our gynecology oncology inpatient unit, coordinating patient care involves multiple teams aiming for discharge objectives. While nurses oversee the care plan, physicians, advanced practice providers, case managers, and other key stakeholders possess essential insights to effective discharge planning. The aim of our study was to evaluate the impact of structured MDR implementation on discharge accuracy, effectiveness, and hospital throughput. Methods: In April 2022, our gynecologic oncology inpatient team implemented structured MDRs to enhance discharge processes, focusing on patient outcomes and hospital throughput. The initiative aimed to identify discharge barriers early, set goals, and address challenges collaboratively through: 1) Interdisciplinary Assessment: Using standardized tools to evaluate patient status and care needs; 2) Review of Clinical Data: Analyzing medical records via EHR systems; 3) Collaborative Decision-Making: Using decision-support tools to set the Estimated Discharge Date (EDD); 4) Patient Engagement: Involving patients and families in shared decision-making; 5) Documentation and Communication: Ensuring clear EDD documentation and effective communication through team huddles, bedside rounds, and discharge planning meetings. EDD reporting, discharge order timing, and patient discharge time were tracked using our Care Team Transformation Dashboard. Results: The implementation of structured MDR led to significant improvements in discharge processes. We observed enhanced accuracy in EDD, with a 2.9% increase, and a notable rise in the completion of discharge orders before 9 am, showing a 60.5% increase (Table). The percentage of patients leaving the hospital before noon increased by 20.4%, highlighting MDRs effectiveness in facilitating timely discharge, enhancing intradisciplinary collaboration, and streamlining discharge efficiency. Conclusions: MDRs play a pivotal role in improving teamwork, quality of care, and patient outcomes. Setting EDDs through structured MDR processes enhances proactive discharge planning, thereby reducing delays and optimizing patient flow, ultimately contributing to the delivery of high-quality, patient-centered healthcare. Measure Preintervention: 1/2023-1/2024 Postintervention02-05/2024 Percentage Increase EDD accuracy 1 day prior 46.9 48.3 2.9% Discharge orders before 9am 33.4 53.6 60.5% Discharges prior to noon 19.1 23.0 20.4%