Abstract

Delays in discharge were creating daily challenges in our hospital—slowing patient flow, limiting available beds, and adding stress to nursing teams. Many patients who were already medically cleared were still staying in inpatient rooms while waiting on transportation, medications, or final instructions. Even though a Discharge Hospitality Suite (DHS) existed, many patients didn’t qualify for it, especially those on isolation, needing mobility help, or going to post-acute facilities like SNFs or LTACHs. This meant many discharge-ready patients were still occupying beds needed for incoming admissions.
To help solve this, our team created an expanded DHS model that could support a wider range of patients and discharge needs. Using the Plan-Do-Study-Act (PDSA) framework, we converted a six-bed observation area into a dedicated discharge space that could safely accommodate more complex patients. Nursing worked with pharmacy, care coordination, and transport to build eligibility criteria, finalize workflows, strengthen communication, and design escalation processes. Staff also received education on outpatient resources and care- transition options so they could better support these patients.
Over the first six months, we tracked patient volume, discharge timing, hours saved, and the types of discharges the DHS supported. Between January 27 and June 30, 2025, the updated DHS discharged 1,642 patients—about 100 patients a week, with a peak of 25 in a single day. The model freed 2,520 inpatient hours, the same as opening up 105 additional bed-days for new admissions. Thirty-six percent of these patients discharged before 1300, which helped earlier ED admissions move upstairs. The discharge mix reflected how inclusive the model became: 900 patients went home, and 742 transferred to SNFs, rehab, LTACHs, home health, or nursing homes.
 
We also saw an improvement in patient experience, especially for those going home. Patients consistently shared that the DHS was quieter, more comfortable, and less stressful than waiting in a busy inpatient hallway or room. Bedside nurses reported less pressure during peak hours because beds were turning over earlier, and leaders noted smoother admission flow throughout the day.
Overall, this project showed that a nurse-led, expanded DHS can make a real impact on patient throughput, care transitions, workload, and hospital capacity—all while maintaining safety. Moving forward, we plan to continue tracking outcomes, work more closely with bed management and post-acute partners, and explore ways to spread this model to other service lines and hospital campuses.