North Texas GME Research Forum 2024



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North Texas


Medical City Arlington


Internal Medicine

Document Type


Publication Date



hospital discharge, quality improvement, discharge orders


Internal Medicine | Medicine and Health Sciences | Quality Improvement


There are several factors preventing discharges out of the hospital within 24 hours that ultimately affects metrics for both hospital systems and physicians. These factors include pending labs, imaging, or procedures; pending placement approval at a facility outside of the hospital upon discharge; notification of family and caretakers; secured funding for devices and medicines; and others. In an attempt to mitigate preventable extra days spent in the hospital once a patient is medically ready for discharge, a Texas hospital implemented a discharge order set for providers to utilize that informs all involved parties including case management, PT/OT, social work, nurses, and others that the patient is medically ready to discharge. This plan was implemented with the primary goal of improving metrics for the hospital and providers that are related to discharge and length-of-stay, and was previously piloted at another hospital in Austin, TX with inconclusive data. The goal, as set by the hospital corporation, was to increase discharges out of the hospital at 11:00 AM and 1:00 PM to 20% and 45%, respectively; before the project was implemented the percentage of discharges by 11:00 AM and 1:00 PM were 7% and 29%, respectively. While it was initially planned to collect data on the rate of use of the order set on one floor, the data was unable to be extracted from data across all floors, so the rate of order set implementation remains unknown. Despite implementation of the order set, the hospital failed to see significant changes in discharge metrics compared to before the order set was implemented, and the order set was abandoned. Future studies on similar measures to improve discharge metrics should include robust data collection methods for detailed analysis of results. Additionally, future studies should be done to see what measures from physician-led notification systems are effective in improving discharge metrics.

Original Publisher

HCA Healthcare Graduate Medical Education

Discharge Implementation Project: Ascertaining if Discharge Implementation Orders Overall Improves Discharge Metrics at a Texas Hospital



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