Skip to Main Content
HBS Home
  • About
  • Academic Programs
  • Alumni
  • Faculty & Research
  • Baker Library
  • Giving
  • Harvard Business Review
  • Initiatives
  • News
  • Recruit
  • Map / Directions
Faculty & Research
  • Faculty
  • Research
  • Featured Topics
  • Academic Units
  • …→
  • Harvard Business School→
  • Faculty & Research→
Publications
Publications
  • Article
  • Annals of Emergency Medicine

The Inpatient Discharge Lounge as a Potential Mechanism to Mitigate Emergency Department Boarding and Crowding

By: Brian Franklin, Sharif Vakili, Robert S. Huckman, Sarah Hosein, Nicholas Falk, Katherine Cheng, Maria Murray, Sheila Harris, Charles A. Morris and Eric Goralnick
  • Format:Print
ShareBar

Abstract

Delayed access to inpatient beds for admitted patients contributes significantly to emergency department (ED) boarding and crowding, which have been associated with deleterious patient safety effects. To expedite inpatient bed availability, some hospitals have implemented discharge lounges, allowing discharged patients to depart their inpatient rooms while awaiting completion of the discharge process or transportation. This conceptual article synthesizes the evidence related to discharge lounge implementation practices and outcomes. Using a conceptual synthesis approach, we reviewed the medical and gray literature related to discharge lounges by querying PubMed, Google Scholar, and Google and undertaking backward reference searching. We screened for articles either providing detailed accounts of discharge lounge implementations or offering conceptual analysis on the subject. Most of the evidence we identified was in the gray literature, with only three peer-reviewed articles focusing on discharge lounge implementations. Articles generally encompassed single-site descriptive case studies or expert opinions. Significant heterogeneity exists in discharge lounge objectives, features, and apparent influence on patient flow. Although common barriers to discharge lounge performance have been documented, including underuse and care team objections, limited generalizable solutions are offered. Overall, discharge lounges are widely endorsed as a mechanism to accelerate access to inpatient beds, yet the limited available evidence indicates wide variation in design and performance. Further rigorous investigation is required to identify the circumstances under which discharge lounges should be deployed as well as how discharge lounges should be designed to maximize their effect on hospitalwide patient flow, ED boarding and crowding, and other targeted outcomes.

Keywords

Health Care Delivery; Emergency Room; Operations Improvement; Operations Management; Health Care and Treatment; Service Delivery; Operations; Management; Performance Improvement; Service Operations

Citation

Franklin, Brian, Sharif Vakili, Robert S. Huckman, Sarah Hosein, Nicholas Falk, Katherine Cheng, Maria Murray, Sheila Harris, Charles A. Morris, and Eric Goralnick. "The Inpatient Discharge Lounge as a Potential Mechanism to Mitigate Emergency Department Boarding and Crowding." Annals of Emergency Medicine 75, no. 6 (June 2020): 704–714.
  • Find it at Harvard

About The Author

Robert S. Huckman

Technology and Operations Management
→More Publications

More from the Authors

    • 2022
    • JACC: Advances

    Investigating the Association Between Telemedicine Use and Timely Follow-Up Care After Acute Cardiovascular Hospital Encounters

    By: Mitchell Tang, A Jay Holmgren, Erin E. McElrath, Ankeet S. Bhatt, Anubodh S. Varshney, Simin Gharib Lee, Muthiah Vaduganathan, Dale S. Adler and Robert S. Huckman
    • August 3, 2022
    • Harvard Business Review (website)

    How Will Amazon Approach U.S. Primary Care?

    By: Robert S. Huckman and Bradley Staats
    • March 2022
    • Journal of the American Medical Informatics Association

    Assessing the Impact of the COVID-19 Pandemic on Clinician Ambulatory Electronic Health Record Use

    By: A Jay Holmgren, Lance Downing, Mitchell Tang, Christopher Sharp, Christopher Longhurst and Robert S. Huckman
More from the Authors
  • Investigating the Association Between Telemedicine Use and Timely Follow-Up Care After Acute Cardiovascular Hospital Encounters By: Mitchell Tang, A Jay Holmgren, Erin E. McElrath, Ankeet S. Bhatt, Anubodh S. Varshney, Simin Gharib Lee, Muthiah Vaduganathan, Dale S. Adler and Robert S. Huckman
  • How Will Amazon Approach U.S. Primary Care? By: Robert S. Huckman and Bradley Staats
  • Assessing the Impact of the COVID-19 Pandemic on Clinician Ambulatory Electronic Health Record Use By: A Jay Holmgren, Lance Downing, Mitchell Tang, Christopher Sharp, Christopher Longhurst and Robert S. Huckman
ǁ
Campus Map
Harvard Business School
Soldiers Field
Boston, MA 02163
→Map & Directions
→More Contact Information
  • Make a Gift
  • Site Map
  • Jobs
  • Harvard University
  • Trademarks
  • Policies
  • Accessibility
  • Digital Accessibility
Copyright © President & Fellows of Harvard College