Findings seen for patients with four common diagnoses during an 18-month quality improvement study
WEDNESDAY, Nov. 5, 2025 (HealthDay News) — A standardized discharge framework improved discharge efficiency for patients with four common diagnoses during an 18-month quality improvement period, according to a study published online recently in BMJ Open Quality.
Colin M. McCrimmon, M.D., Ph.D., from the University of California, Los Angeles (UCLA), and colleagues developed consensus-based discharge criteria coupled with a standardized discharge pathway for four presenting diagnoses (transient ischemic attack, seizure, demyelinating disease, or syncope) and tracked their effect on discharge timing and length of stay (LOS). The analysis included 318 total patient visits across six months preintervention and 12 months postintervention. The primary outcome was a discharge time of two hours or less for 60 percent of patients during the implementation period. Secondary outcomes included reduced time to discharge (TTD) and LOS compared with the preintervention period.
The researchers found that median TTD improved from 171 minutes at baseline to 88 and 92 minutes, respectively, during the implementation and postimplementation periods. There was also a decrease in median LOS from 94 hours to 35 and 30 hours, respectively. During the implementation period, all primary and secondary outcomes were achieved and sustained postimplementation. Within 30 days postintervention, the rate of emergency department visits and hospital readmissions remained low (~1.5 percent). Most providers reported that the intervention improved clinical workflow.
“We replaced arbitrary, physician-specific discharge decisions with consensus-based criteria developed by neurology and medicine specialists,” lead author Melissa Reider-Demer, D.N.P., also from UCLA, said in a statement. “This allowed our entire care team including nurses, pharmacists, case managers and transport staff to predict and coordinate discharges more efficiently.”
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