PMID- 26425247
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20151001
LR  - 20200930
IS  - 1941-8744 (Print)
IS  - 1941-8752 (Electronic)
IS  - 1941-8744 (Linking)
VI  - 5
IP  - 4
DP  - 2015 Oct
TI  - Facilitating Early-In-Day Discharge for Multiple Sclerosis Patients Treated With 
      Intravenous Methylprednisolone: A Quality Improvement Project.
PG  - 197-204
LID - 10.1177/1941874415576206 [doi]
AB  - BACKGROUND AND PURPOSE: Delays in patient hospital discharge affect care value 
      through costs of prolonged length of stay and barriers to patient flow within the 
      hospital. We sought to facilitate early-in-day discharges (EIDDs) without 
      extending length of stay for inpatients with multiple sclerosis admitted for 
      acute exacerbations and treated with intravenous (IV) methylprednisolone. 
      METHODS: We developed a standardized admission order set, a provider checklist, 
      and a patient checklist to better coordinate in-hospital care and discharge 
      planning for patients with multiple sclerosis admitted for IV methylprednisolone 
      treatment. The order set allowed providers to enter an accelerated dosing 
      schedule of methylprednisolone, as appropriate, to ensure administration of the 
      final dose of methylprednisolone in the morning on the anticipated day of 
      discharge. We compared a prospective intervention cohort to a retrospective, 
      preintervention baseline cohort. RESULTS: At baseline (N = 25), 12.0% of patients 
      were EIDD compared to 40.7% of intervention patients (N = 27; P = .03). In all, 
      85.2% of intervention patients compared to 64.0% of baseline patients were 
      discharged on the same day as last methylprednisolone treatment (P = .11). No 
      difference was observed in median length of stay and 30-day readmission rate 
      between groups. CONCLUSIONS: Use of a standard admission order set as well as 
      provider and patient checklists can facilitate EIDD and hospital bed availability 
      without compromising care quality for a select group of neurology inpatients.
FAU - Probasco, John C
AU  - Probasco JC
AD  - Department of Neurology, Johns Hopkins Hospital, Baltimore, MD, USA.
FAU - Hawley, Gina
AU  - Hawley G
AD  - Department of Neurosciences, Johns Hopkins Hospital, Baltimore, MD, USA.
FAU - Burnett, Margie
AU  - Burnett M
AD  - Department of Neurosciences, Johns Hopkins Hospital, Baltimore, MD, USA.
FAU - Gibson, Lorrie
AU  - Gibson L
AD  - Department of Neurosciences, Johns Hopkins Hospital, Baltimore, MD, USA.
FAU - Carter, Kathryn
AU  - Carter K
AD  - Department of Neurology, Johns Hopkins Hospital, Baltimore, MD, USA.
FAU - Harlow, Elizabeth
AU  - Harlow E
AD  - Department of Neurosciences, Johns Hopkins Hospital, Baltimore, MD, USA.
FAU - Russell, Holly
AU  - Russell H
AD  - Department of Physical Medicine and Rehabilitation, Johns Hopkins Hospital, 
      Baltimore, MD, USA.
FAU - Huffman, Linda
AU  - Huffman L
AD  - Department of Neurosciences, Johns Hopkins Hospital, Baltimore, MD, USA.
FAU - Adams, Jane
AU  - Adams J
AD  - Department of Neurosciences, Johns Hopkins Hospital, Baltimore, MD, USA.
FAU - Ziegler, Terry
AU  - Ziegler T
AD  - Department of Medicine and Surgery Social Work, Johns Hopkins Hospital, 
      Baltimore, MD, USA.
FAU - Sporney, Hilary
AU  - Sporney H
AD  - Department of Quality Improvement, Johns Hopkins Hospital, Baltimore, MD, USA.
FAU - Levy, Michael
AU  - Levy M
AD  - Department of Neurology, Johns Hopkins Hospital, Baltimore, MD, USA.
FAU - Puttgen, Hans A
AU  - Puttgen HA
AD  - Department of Neurology, Johns Hopkins Hospital, Baltimore, MD, USA.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Neurohospitalist
JT  - The Neurohospitalist
JID - 101558199
PMC - PMC4572382
OTO - NOTNLM
OT  - multiple sclerosis
OT  - quality
COIS- The authors declared the following potential conflicts of interest with respect 
      to the research, authorship, and/or publication of this article: He serves as a 
      consultant for Chugai Pharmaceuticals, Glaxo-Smith-Kline, and MedImmune.
EDAT- 2015/10/02 06:00
MHDA- 2015/10/02 06:01
PMCR- 2015/10/01
CRDT- 2015/10/02 06:00
PHST- 2015/10/02 06:00 [entrez]
PHST- 2015/10/02 06:00 [pubmed]
PHST- 2015/10/02 06:01 [medline]
PHST- 2015/10/01 00:00 [pmc-release]
AID - 10.1177_1941874415576206 [pii]
AID - 10.1177/1941874415576206 [doi]
PST - ppublish
SO  - Neurohospitalist. 2015 Oct;5(4):197-204. doi: 10.1177/1941874415576206.