How Hospital Medicine Leaders Can Improve Discharge Efficiency Without Burning Out Their Teams

Hospital medicine teams are under increasing pressure to improve discharge efficiency, balance provider workloads, and reduce burnout — all while maintaining patient throughput and operational flow. Yet the metrics tied to discharge performance are often misunderstood, inconsistently measured, or misaligned with how teams actually work. 

This blog clarifies the most important discharge-related metrics, explains the nuances that can mislead leaders (like counting discharges at order-entry time rather than physical patient departure), and illustrates how Medaptus Assign brings transparency, balance, and actionable insights to discharge planning. The goal is to empower leaders with a clearer understanding of what to measure, why it matters, and how Assign supports more efficient and equitable workflows. 

Why Discharge Management Matters More Than Ever 

Discharging patients is one of the most time-consuming and complex parts of managing a patient’s stay during the hospital. Providers are responsible for creating a detailed discharge plan which requires a lot of clerical work and documentation. They have to summarize the patient’s entire stay: their H&P, what was discussed or conducted during previous rounding; the reason they’re being sent home; and reconciling all their medication. In addition to documenting the reason for discharge, post-hospital plans are often considered (such as discharging to a rehab facility, or receiving nursing care at home). 

Because of the amount of work that’s required to discharge patients, hospitalists don’t want to be handed off patients close to discharge – because the new hospitalist would only see them once or twice before discharge, compared to the previous doctor who saw them for their entire stay. Now the new doctor is responsible for the discharge plan.  

That’s why hospitalists try to maintain continuity of care throughout the patient’s stay, and specifically as they get closer to being ready to be discharged. If a patient who was ready to be discharged is assigned to a different hospitalist, that doctor may want them to stay longer so they can double check the patient before discharging, which delays discharges. 

Discharge Metrics Hospital Medicine Groups are Accountable for 

The ultimate goal of discharging is improving throughput, safely. There are a few discharge-related metrics that hospital medicine groups are held responsible for:  

• Readmission rates: The goal is to avoid a patient readmission (within 7 days or 30 days) 

• Discharges per provider: It’s common to feel like there are some hospitalists who are “better” at discharging than others. Providers are measured on how their discharge rates compare to other providers  

• Discharges before noon: Although difficult to achieve, it helps the entire hospital if patients are discharged earlier in the day – because then you can fill the bed with a new patient (and start charging them).  

• Hospital medicine length of stay vs. overall length of stay: Each diagnosis has an average length of stay that insurances cover – you ideally want to get the patient safely out before that time lapses, otherwise the hospital is losing money. However, that’s not always up to the hospital medicine team – so we encourage teams to look at the patient’s total length of stay (from the time they were admitted, maybe they spent two days in the ICU etc.) and then the total length of stay in the hospital medicine group separately, to get a more accurate picture of the hospital medicine team’s efficiency  

How Medaptus Assign Improves Discharge Efficiency 

In order to discharge safety and efficiently, and hit these metrics, it all starts with making sure that patients are assigned to the right provider. Here’s how Assign helps: 

1. Evenly balance new patients: We evenly balance new admissions so no doctor is overloaded with a high volume of new patients. New patients require more work the first few days of their stay when they are sickest so there’s less of a chance they can get patients out the door. By balancing new patients evenly, we ensure hospitalists have an even workload – more time to work on seeing new patients and discharging existing patients.
2. 1:1 handoffs: When a doctor is going off shift (ex. Working 7 on, 7 off), they are going to try and safely discharge patients before they leave. Assign automatically assigns patients from one hospitalist to another based on the workflow that makes sense for your hospital (ex. When Dr. Jones goes off, assign all his patients to Dr. Smith; or when Dr. Jones goes off, assign only his patients in a certain geography to Dr. Smith)
3. Ensure the entire care team is informed of changes: Assign automatically updates the Attending in your EHR to ensure the entire care team is informed when a provider changes. This ensures no missing patients and that every patient is rounded on – especially important when doctors work 7 on, 7 off, and an entire patient population changes over in one day.
4. Avoid the discharge “tax.” For many hospitalists, if they discharge two patients today, they get two new patients tomorrow – which ends up being more work. With Assign, you can remove this burden by weighing new patients as 1.5 (a patient and a half), so hospitalists that discharge don’t get the same number of patients, but the same volume of work.
5. Keep your patients assigned to you, no matter what. One healthcare organization we work with has a rule in Assign: When a patient is over a certain amount of days in their hospitalization, the hospitalist keeps that patient no matter what – so that way a patient doesn’t have to start with a new provider in the middle of their long stay.
6. Predict who will be ready for discharge. Another healthcare organization we work with flags patients that are ready for discharge in Assign. By flagging those when they do their assignments in the morning, hospitalists know they should round on those patients first to get them discharged by noon.
7. Readmits? Assign to the last provider. If a patient is readmitted within 7 or 30 days, Assign can ensure they get automatically assigned to the last hospitalist who saw them. Better for the patient, better for the hospitalist who knows their history. 

Discharge management is a complex process that involves multiple people – from the care team to the administrative staff and beyond. Since hospitalists are providing care every day to patients, they have a huge influence on how and when patients are discharged. Understanding what impacts efficient discharges can drastically improve patient throughput and help patients get where they want to go: back home, safe and sound. 

FAQs

Q: What is a “discharge ratio” in hospital medicine? 
A: It measures how many discharges each provider performs relative to their census or peers. It helps leaders monitor equity and productivity. 

Q: Why is “discharges before noon” such an important metric? 
A: Earlier discharges free up beds, improve throughput, and reduce bottlenecks for admissions — particularly from the ED and procedural areas. 

Q: Why do some systems calculate discharge timing based on order placement? 
A: Many EMRs default to order-entry timestamps, which can misrepresent actual workflow. Leaders should understand which timestamp their metrics use. 

Q: How does provider workload impact discharge efficiency? 
A: Overloaded providers have fewer morning hours to complete discharge prep, delaying orders and contributing to burnout and imbalance. 

Q: How does Medaptus Assign help improve discharge outcomes? 
A: Assign automates patient distribution, balances workloads, identifies discharge-ready patients early, and supports predictable and equitable rounding workflows.