UCLA Health Cuts Patient Discharge Times by Nearly 50%

A pilot study at UCLA Health has demonstrated a significant reduction in hospital discharge times, nearly cutting the waiting period by 50%. This improvement, which affects patients with four common diagnoses, also led to a decrease in the overall length of hospitalization by an average of 2.5 days. The findings, published in the journal BMJ Open Quality, suggest that implementing standardized discharge criteria could benefit hospitals struggling with bed capacity and patient flow.

Over the course of 18 months, the Ronald Reagan Medical Center focused on enhancing discharge processes for patients diagnosed with transient ischemic stroke, seizures, demyelinating diseases, and syncope (fainting). Researchers gathered input from various stakeholders involved in patient care, creating a standardized set of criteria for discharges. The aim was to streamline the process and reduce both discharge times and inpatient stays.

The results were striking. The median time from when discharge orders were placed to when patients actually left the hospital dropped from 171 minutes to 88 minutes, a reduction of 49%. Additionally, the median length of hospital stays decreased significantly, and these improvements remained evident even six months after the new criteria were implemented, with discharge times stabilizing at 92 minutes and median stays further declining to just 30 hours.

Dr. Melissa Reider-Demer, the study’s lead author and a DNP at UCLA Health, emphasized the importance of transitioning from inconsistent physician-specific discharge decisions to a standardized framework. She noted, “This allowed our entire care team—including nurses, pharmacists, case managers, and transport staff—to predict and coordinate discharges more efficiently.”

The study included 318 patient visits across UCLA Health’s emergency, observation, and inpatient neurology units. Prior to implementing the new criteria, researchers measured baseline discharge times and lengths of stay over a six-month period. Following the introduction of the standardized criteria, the majority of patients—over 80%—were discharged within two hours of orders being placed. Notably, hospital readmission rates in the emergency room remained low at approximately 1.5%.

The transition to consensus-based discharge criteria has been endorsed by the Institute for Healthcare Improvement, a nonprofit organization advocating for better health care practices. Dr. Reider-Demer explained, “Previously, different doctors had different thresholds for when patients were ready to go home. Establishing clear, consensus criteria mitigates delays due to variable provider preferences and empowers discharging providers.”

While the consensus-based criteria and pathways are tailored to specific hospitals, Dr. Reider-Demer believes that the framework developed at UCLA Health can serve as a model for other institutions facing similar challenges with patient discharge processes. The study offers valuable insights not just for neurology and medicine services, but potentially for other health conditions and departments as well.

Overall, the UCLA pilot study highlights the effectiveness of standardized discharge protocols in enhancing patient flow and improving the overall efficiency of hospital services.