September Journal: Virtual multidisciplinary rounds reduce length of stay, improve throughput

Traditional, in-person multidisciplinary rounds (MDRs) in patient care units are shown to reduce length of stay (LOS) and improve throughput. A new study in the September 2023 issue of The Joint Commission Journal on Quality and Patient Safety sought to determine whether virtual MDRs could also reduce LOS and improve throughput, as well as promote accountability and reduce provider variation. 

Researchers at Yuma Regional Medical Center, Arizona, designed and implemented virtual multidisciplinary rounds via phone conference calls with key stakeholders, including hospitalists, case managers, the clinical documentation improvement team, physical and occupational therapy, and nursing leaders. 

To track progress in real time, dashboards were created using data from electronic medical records. After several months, unit-based discharge huddles were added to supplement the process and sustain the improvement. 

The interventions led to more than 60% of discharges below geometric mean LOS after starting the initiative, compared to approximately 52% before the initiative. Mean observation hours went from 44 hours to 31.9 hours, and the change was sustained for more than a year. A total of 3,813 excess days were reduced in 10 months, resulting in a combined savings of $6.7 million. Additionally, a decrease in hospitalist provider variation was noted. 

The researchers determined that virtual MDRs combined with other interventions can effectively reduce LOS and observation hours. Decreased variation among hospitalists and improved key stakeholder engagement can also be achieved with virtual MDRs. 

Also featured in the September issue are:

• Longitudinal Patterns in Testosterone Prescribing After US FDA Safety Communication in 2014 (Agency for Healthcare Research and Quality, Rockville, Maryland)
• The Positive Predictive Value of Hospital Discharge Data for Identifying Severe Maternal Morbidity with and Without Blood Transfusion (University of Southern California Medical Center, Los Angeles)
• Optimizing PROM Implementation in Orthopedic Clinics for Longitudinal Outcome Monitoring: Lessons from a Multisite Study (12 U.S. orthopedic practices)
• Sociotechnical Work System Approach to Occupational Fatigue (University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin)
• A Novel Web-Based and Mobile Application to Measure Q1 Real-Time Moral Distress: An Initial Pilot and Feasibility Study (University of Virginia, Charlottesville, Virginia)
• Preventing Light Source–Related Burns from Laparoscopy and Arthroscopy (The Joint Commission, Oakbrook Terrace, Illinois)
• 2022 John M. Eisenberg Patient Safety and Quality Award recipients:
  • An Interview with Jason S. Adelman, MD, MS 
  • Anesthesia Risk Alert Program: A Proactive Safety Initiative

Access the Journal.