Patients discharged from a university hospital operating at full capacity are often delayed. Inpatient cardiology is already highly efficient, and length of stay has been maximally shortened. The addition of a nurse‐practitioner to a resident team represents a novel way to further streamline hospital discharges.
The goals of the study were to study the effect of the addition of a nurse‐practitioner to a high‐priority inpatient cardiology service with the goal of shortening time to discharge from the hospital and also to determine if the addition of a nurse‐practitioner enhanced patient counseling and postdischarge outcomes.
Patients were consecutively assigned to either a resident team or a resident team with the addition of a nurse‐practitioner. Data was acquired over a 4‐week period in 2006 for a total of 72 discharges, 36 patients in each group. The data were analyzed to examine potential differences in the time to discharge from the hospital, discharge planning, and patient counseling.
Patients assigned to the nurse‐practitioner (NP) team were discharged on average at 12:29 (CI: 11:46‐13:12), whereas patients assigned to the resident‐only team were discharged at 14:07 (CI: 13:05‐14:55). In addition, 53% of patients were discharged before noon in the NP arm of the study compared to 14% of patients in the resident‐only arm. There was no significant difference in the number of patients discharged on appropriate medical therapy, including aspirin, beta‐ers, ACE inhibitors, and statins. Patients were equally likely to obtain postdischarge instructions, including cardiac rehabilitation and instructions on activity level. Patients discharged by the NP group were more likely to have smoking cessation counseling than were those discharged by the resident‐only group (25% vs. 14%). The opportunity costs generated by earlier discharges were not directly measured in this pilot study. The next phase will attempt to quantify cost benefits through capture of outside hospital transfers, shortened bed‐turnover time, lower readmission rates, and improved patient satisfaction.
T. Danilov, None; P. Zimetbaum, None.
To cite this abstract:Danilov T, Zimetbaum P. A Pilot Study: Nurse‐Practitioners Improve Inpatient Time to Discharge. Abstract published at Hospital Medicine 2007, May 23-25, Dallas, Texas Abstract 16. Journal of Hospital Medicine. 2007; 2 (suppl 2). https://www.shmabstracts.com/abstract/a-pilot-study-nursepractitioners-improve-inpatient-time-to-discharge/. Accessed January 18, 2020.