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减少延误,改善流程:医院出院计划中设立专职出院协调员的重要性。

Reducing Delays, Improving Flow: The Importance of a Dedicated Discharge Coordinator in Hospital Discharge Planning.

作者信息

Bechir George, Bechir Angelina

机构信息

Hospital Medicine, Franciscan Health Munster, Munster, USA.

Genetics and Biochemistry, Clemson University, Clemson, USA.

出版信息

Cureus. 2025 Jun 12;17(6):e85879. doi: 10.7759/cureus.85879. eCollection 2025 Jun.

Abstract

Hospital discharge remains one of the most vulnerable stages of inpatient care, frequently delayed not by clinical need but by fragmented coordination of tasks such as imaging, consults, documentation, and transportation. These bottlenecks contribute to prolonged length of stay (LOS), emergency department crowding, higher healthcare costs, and decreased patient satisfaction. In this article, we examine the critical role of a dedicated discharge coordinator - a nurse, nurse practitioner, or case manager - who is tasked solely with tracking and resolving same-day discharge barriers in real time. Drawing on findings from 20 peer-reviewed studies, we synthesize evidence demonstrating that such centralized oversight reduces LOS (often by 0.5 to 1 day), improves patient throughput, decreases readmission rates, and enhances communication between care teams. We explore various coordination models, ranging from unit-based facilitators to electronic health record (EHR)-integrated tracking tools, and present real-world examples where minor misalignments in timing, such as delayed dialysis or unscheduled imaging, led to avoidable hospital days, reinforcing the need for structured and accountable discharge management. The discharge coordinator acts as the operational "traffic controller" of inpatient flow, ensuring timely, safe, and coordinated transitions of care. In today's strained hospital systems, this role is essential for maintaining safety, efficiency, and capacity.

摘要

医院出院仍是住院治疗中最脆弱的阶段之一,经常不是因为临床需要而延迟,而是由于影像检查、会诊、文件记录和交通等任务的协调不畅。这些瓶颈导致住院时间延长、急诊科拥挤、医疗成本增加以及患者满意度下降。在本文中,我们探讨了专职出院协调员(护士、执业护士或病例管理员)的关键作用,其任务是实时跟踪和解决当日出院障碍。借鉴20项同行评审研究的结果,我们综合了证据,表明这种集中监督可缩短住院时间(通常缩短0.5至1天)、提高患者周转率、降低再入院率并加强护理团队之间的沟通。我们探讨了各种协调模式,从基于病房的协调员到集成电子健康记录(EHR)的跟踪工具,并列举了一些实际例子,说明时间上的微小偏差,如透析延迟或非计划内的影像检查,如何导致了可避免的住院天数,这进一步凸显了结构化和可问责的出院管理的必要性。出院协调员充当住院流程的运营“交通管制员”,确保及时、安全和协调的护理过渡。在当今紧张的医院系统中,这一角色对于维持安全性、效率和容量至关重要。

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