Early discharge and its effect on ED length of stay and access block

Abstract. Effecting early discharge is a widely recommended strategy for improving patient flow in acute hospitals. This paper analyses the impact of inpatient discharge timing on Emergency Department (ED) flow parameters such as access block and length of stay, while comparing this to the effect on hospital occupancy, to arrive at an understanding of a ‘whole of hospital ’ response to discharge timing. The impact of hospital size is also investigated. The analysis reveals that, on days when the discharge peak lags the peak in inpatient admissions, hospitals of all sizes exhibit increased levels of occupancy, inpatient and ED length of stay, and access block. The findings corroborate the efficacy of early discharge initiatives and ‘whole of hospital ’ flow improvement initiatives for addressing overcrowding and efficiency issues in hospitals