A small but significant portion of UCDMS inpatients have been medically cleared discharge but are unable to be placed for weeks to months.
Extended boarding in hospital beds is harmful to patients
• Patients are at risk for falls or hospital acquired infections.
• Hospital beds lack privacy and quiet offered by lower levels of care, which is especially unhealthy for patients with psychiatric or neurocognitive comorbidities.
Extended boarding in hospital beds is expensive and wasteful
• Care at UCDMC is significantly more expensive than at lower levels of care, so weeks or months spent at a higher than necessary level of care represents a significant and unnecessary expenditure of resources.
From January to December, 2019, there were 53 adult patients with LOS>100 days. 17 of those patients were medically justified for staying that long and were discharged within a week of medical clearance. The rest, 36 patients, were discharged 13 to 732 days (mean of 218 days) after medical clearance.
The factors associated with LOS Outliers have been described, but previous studies have not focused on a populations with such large minimum LOS. This study seeks to characterize and quantify the barriers to discharge faced by LOS>100 patients who have been medically cleared but have difficulty finding placement at a lower level of care.
