Impact of Discharge Rounds on Patient Flow and Hospital Outcomes

Abstract

Discharge delays are a common and costly problem in hospitals, exposing patients to preventable risks while straining system capacity. Discharge rounds are structured daily meetings designed to identify barriers and coordinate care, and have emerged as a potential solution, yet implementation varies widely across institutions. This narrative review examined 38 studies published between 2010 and 2024 that evaluated discharge rounds in adult acute care hospitals. The evidence demonstrated that outcomes depend more on execution than on the concept itself. Hybrid formats that combine in-person and virtual participation improved attendance and preserved communication quality. Early morning rounds of limited duration facilitated timely discharges and aligned better with hospital operations. A lean but interdisciplinary core team of hospitalists, case managers, and nurses was consistently effective, with pharmacists and social workers adding value in select populations. Nursing participation models required tailoring. Bedside nurse involvement proved beneficial in high-acuity settings, while charge nurse representation was effective in more stable units. Geographic cohorting of physicians reduced inefficiency from multi-floor coverage, although handoffs raised continuity concerns. Across all models, the most successful rounds focused their discussion on discharge readiness, specific barriers, assigned responsibilities, and clear timelines rather than broad clinical debates. Programs that lacked structure or drifted from this focus often failed to achieve measurable benefits. In conclusion, discharge rounds can reduce length of stay and improve hospital efficiency, but only when carefully designed. Hospitals seeking to implement or refine discharge rounds should prioritize format, timing, team composition, and discussion focus while adapting to local context.

Keywords: acute care hospitals; discharge planning; discharge rounds; hospital efficiency; hospital length of stay; interdisciplinary communication; multidisciplinary rounds; patient flow; patient safety; virtual rounds.