• J Gen Intern Med · Jan 2025

    Identifying Core Functions and Forms of "Discharge by Noon" Interventions.

    • Jigisha Patel, Sachita Shrestha, Ruby Marr, Paul Caseley, Megan Mack, Vijay Singh, David Paje, Robert Chang, and Stephanie Parks Taylor.
    • Division of Hospital Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA. jigpat@med.umich.edu.
    • J Gen Intern Med. 2025 Jan 21.

    BackgroundMany hospitals have implemented Discharge by Noon (DBN) programs to improve hospital throughput but have had mixed results.ObjectiveUse a complex health intervention framework to define core functions and forms of DBN interventions.DesignQualitative study combined with scoping review.SettingTwo hospitals in Michigan, USA.ParticipantsMultidisciplinary stakeholders (n = 22) involved in the development and implementation of a DBN program.MeasurementsWe conducted (1) stakeholder surveys and (2) a scoping review of the DBN literature. We integrated quantitative and qualitative data to develop a DBN functions and forms matrix.ResultsQualitative thematic analysis of the stakeholder survey identified six core functions addressing five motivating needs for a DBN program, and the scoping review identified one additional core function addressing one additional motivating need. We identified 17 eligible studies for the scoping review, of which 15 (88%) found an improvement in DBN associated with the intervention and two (12%) did not. Compared with ineffective interventions, a greater proportion of effective ones enabled multi-disciplinary participation (76% vs 0%), provided a structured platform for communication (65% vs 0%), and enabled pre-identification of patients (59% vs 0%). Cross-case analysis revealed that programs that included either enablement of multi-disciplinary participation or structured platform for communication covered 100% of effective interventions and no ineffective ones.ConclusionSuccessful DBN programs include specific core functions. Our findings can guide system recommendations about optimal DBN intervention structures to maximize effectiveness and resource stewardship.© 2025. The Author(s), under exclusive licence to Society of General Internal Medicine.

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