An evaluation of physician predictions of discharge on a general medicine service.
Abstract
The goal of this study was to evaluate general medicine physicians' ability to predict
hospital discharge. We prospectively asked study subjects to predict whether each
patient under their care would be discharged on the next day, on the same day, or
neither. Discharge predictions were recorded at 3 time points: mornings (7-9 am),
midday (12-2 pm), or afternoons (5-7 pm), for a total of 2641 predictions. For predictions
of next-day discharge, the sensitivity (SN) and positive predictive value (PPV) were
lowest in the morning (27% and 33%, respectively), but increased by the afternoon
(SN 67%, PPV 69%). Similarly, for same-day discharge predictions, SN and PPV were
highest at midday (88% and 79%, respectively). We found that although physicians have
difficulty predicting next-day discharges in the morning prior to the day of expected
discharge, their ability to correctly predict discharges continually improved as the
time to actual discharge decreased. Journal of Hospital Medicine 2015;10:808-810.
© 2015 Society of Hospital Medicine.
Type
Journal articleSubject
Clinical CompetenceForecasting
General Practice
Humans
Patient Discharge
Physicians
Prospective Studies
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https://hdl.handle.net/10161/12041Published Version (Please cite this version)
10.1002/jhm.2439Publication Info
Sullivan, B; Ming, D; Boggan, JC; Schulteis, RD; Thomas, S; Choi, J; & Bae, J (2015). An evaluation of physician predictions of discharge on a general medicine service.
J Hosp Med, 10(12). pp. 808-810. 10.1002/jhm.2439. Retrieved from https://hdl.handle.net/10161/12041.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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Show full item recordScholars@Duke
Jonathan Gregory Bae
Associate Professor of Medicine
Patient safety and quality improvement, hospital based performance improvement, care
transitions and hospital readmissions, general internal medicine hospital care, resident
and medical student education.
Joel Boggan
Associate Professor of Medicine
I am a hospital medicine physician interested in quality improvement, patient safety,
and medical education across the UME, GME, and CME environments. My current QI and
research projects include work on readmissions, inpatient ORYX and patient experience
measures, clinical documentation improvement, medication reconciliation, and appropriate
utilization of inpatient resources. Alongside this work, I serve as the lead mentor
for our Durham VA Chief Resident in Quality and Safety within the Depart
David Yung Ming
Associate Professor of Medicine
I am a med-peds hospitalist and researcher with interests in improving systems of
care of patients with complex health needs. My research focus areas include implementation
science, population health sciences, community-engaged research, and digital health.
My vision is to design, implement, evaluate, and scale programs and interventions
that will simplify the delivery of complex care. By doing so, we can equitably improve
the health outcomes that matter most to children and adults with compl
Ryan D Schulteis
Assistant Professor of Medicine
Brian Sullivan
Assistant Professor of Medicine
I am a Physician Scientist in Gastroenterology, with a research focus in optimizing
colorectal cancer (CRC) screening and surveillance recommendations. This includes
evaluating current and evolving CRC screening strategies and identifying people at
high risk for underlying hereditary/genetic CRC syndromes.
Samantha Thomas
Biostatistician, Principal
Samantha is the manager of the Duke Cancer Institute (DCI) Biostatistics Shared Resource.
Collaboratively, she primarily works with physicians in DCI, specifically in research
of Endocrine Neoplasia and Breast Cancer. She is also the director of the Biostatistics,
Epidemiology, Research, and Design Methods (BERD) Core Training and Internship Program
(BCTIP). Her professional experience involves study design, analysis, and reporting
of clinical trials and observational studies. Her specific areas
Alphabetical list of authors with Scholars@Duke profiles.

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