Project Aims

Background

At the end of 2019, severe acute respiratory syndrome coronavirus 2 (SARSCoV-2), a novel coronavirus, was identified as the cause of an acute respiratory illness epidemic in Wuhan, China. The World Health Organization (WHO) termed this illness Coronavirus Disease 2019 (COVID-19)¹². COVID-19 spread around the world, becoming a pandemic infecting millions of individuals. Despite the significant disruption to global and national economies resulting from widespread shelter-in-place directives, the pandemic is expected to continue for the foreseeable future.

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IMPROVING FIRST CASE ON TIME STARTS, UCSF BENIOFF CHILDREN’S HOSPITAL OAKLAND

ABSTRACT

Adult medicine patients are frequently discharged to skilled nursing facilities (SNF). The complex workflow requires input from multiple clinical and allied professionals and as a result often leads to preventable delays.¹ In 2019, 14% of discharges from the Hospital Medicine service at UCSF Parnassus were to SNF. These inpatient-to-SNF transitions can be complicated, rushed, and an ad hoc workflow results in higher lengths of stay (LOS) and worse patient experience.² Last year, on the Hospital Medicine service, SNF-bound patients had an average length of stay more than three days longer than non-SNF bound (9.8 vs 6.4 days). We observed multidisciplinary rounds over a 7-day period in February 2020, and found patients identified as potential SNF discharges had preventable delays, commonly related to physical therapy evaluation as well as patient and family SNF selection.