e13555 Background: Hospital capacity constraints impact patient access, team workflows, and overall efficiency of care. Multidisciplinary Rounds (MDRs) are the cornerstone for patient flow activities. Capacity issues highlight the acute need for innovation and rapid change. MDRs are led by Registered Nurse (RN) Case Manager Navigators and had a rigid structure that hindered adaptability and participation for various oncology disciplines. Using stakeholder input, MDRs were redesigned to facilitate adaptability for oncology service-specific needs, coordination of activities prior to discharge, and increased collaboration. The purpose was to improve MDR efficiency and effectiveness to reduce discharge barriers and improve overall team satisfaction. Methods: In 2022, consultants were engaged to study our process and recommend nationally accepted MDR practices. With recommendation, we started full census reviews to establish comprehensive discharge plans. In 2024, stakeholder survey feedback highlighted inefficiencies and dissatisfaction with the revised MDR practices. Two strategies were used to address these concerns. 1: Survey data from hematology, solid tumors, and surgical cohorts were analyzed for themes. 2: A pilot was implemented, focusing discussions on patients within two days of discharge or with anticipated complex discharge plans. Results: Survey results revealed inconsistent practices and common themes across cohorts, such as the desired location of MDRs, timing, content, and key participants required by unit. The pilot led to significant improvements in participation among providers and other team members, effective communication, reduced total time, and greater verbalized satisfaction with the process. Lessons learned were leveraged to enhance MDR redesign for other services. The primary metric to gauge success of the revamped MDRs was accuracy of the estimated discharge date (EDD) by 9AM the day before discharge. The secondary metric was adoption of morning (AM) / afternoon (PM) discharge time designations, referred to as time of day (TOD). From baseline to pilot completion, EDD accuracy increased from 45% to 53% and TOD selection increased from 31% to 49%. Additionally, completion of discharge orders by 9AM increased by 37.5%, with 35% more patients leaving the hospital before noon. Our MDR change initiative led to quantifiable positive downstream outcomes. Conclusions: The latest MDR format led to highly effective processes showcasing teamwork and care quality. Customizing unit-specific MDRs improved participation, increased EDD accuracy and TOD selection. This allowed teams to better prepare patients for discharge and ensure discharge orders were entered by 9AM to improve patient discharge before noon. We were successful in incorporating varied perspectives in MDR redesign, which contributed to the overall goal of alleviating hospital capacity issues.
Wilson et al. (Thu,) studied this question.