Reducing hospital admission delay times using a structured, systematic, multi‐disciplinary approach Article Swipe

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medicine audit handover hospital admission emergency medicine internal medicine computer science management economics computer network

Nathan Baskin , Kavon Javaherian , Josué Zapata , Robert Litwin , Charlie M. Wray ·

YOU? · · 2025 · Open Access · · DOI: https://doi.org/10.1002/jhm.70050 · OA: W4409516400

A 6‐month audit at the San Francisco VA Health Care System (October 2020 to March 2021) found a median admission delay of 207 min, higher than the national VA median of 146 min. A multi‐disciplinary team found that factors contributing to this delay included unclear bed assignment processes, nursing handoff delays, and over‐reliance on inpatient teams to initiate admission processes. After implementing three countermeasures—(1) bed assignment standardization, (2) nursing handoff improvement, and (3) skeletal admission orders—median admission delay decreased by 29.5%, from 207 to 145 min, over a 3‐month period which has sustained since the changes were implemented.