March 15, 2023

Accelerate Throughput by Optimizing Discharge Planning & Post-Acute Placement Across Care Settings: Part 2

By Jen Eriks, LMSW, Client Outcomes Engineer, ABOUT 


Health systems are facing pervasive challenges in discharge planning and post-acute placement across the nation. The Average Length of Stay (ALOS) has gone up by 24% in the last three years for patients needing post-acute care services after inpatient care.


In part one of this blog series, my colleague Gina Kidder covered the root causes of these challenges and solutions relating to people and personnel. In part 2, I will cover solutions within process, technology, and network strength.





Process is at the center of successful care management. Here are our top tips for optimizing multidisciplinary rounds (MDRs) and additional processes.

  • Optimize MDRs – Ensure the right disciplines are involved and reinforce anticipated discharge dates. Identify any barriers to discharge each morning to open capacity for afternoon admits.
  • Make the most of morning CM specific team huddles – Share big picture information from across the system such as ED wait times, barriers to discharge, and caseloads so the team can collaborate on solutions.
  • Implement a discharge lounge – If patients don’t have a ride by 11am, offer for them to go to the discharge lounge so that bed can be turned over for the next patient’s care. Scripting pertaining to this lounge is crucial to its success.
  • Bring the prior authorization process into the health system – To control costs and create efficiencies. Bringing prior authorization in house reduces wait times and uncertainty when all other items have been cleared for discharge.



Automated referral management and PAC placement is essential to driving efficiency. For example, we’ve seen consistent results with clients who were spending, on average, 20 hours a week on administrative work per employee. This decreases to 2 hours a week just by switching to an automated electronic solution. Here are some things to look for in PAC placement technology:

  • Advanced data and analytics – For visibility into referral patterns, performance, volume, and discharge barriers.
  • Patient Choice application – An electronic-based solution for patients to search, filter, and select their top preferred PAC locations.
  • Automated transportation coordination – Integrated with computer aided dispatch (CAD) systems to empower care teams to digitally request, coordinate, and track transport.
  • Expertise and partnership – Comprehensive consulting, best practices, support, and change management to ensure you’re getting the most out of your technology, and to identify trends and insights in your data.
  • One platform for all care settings – You want a solution that can be used across care management departments for systemwide controls and visibility.


For example, the ABOUT Post-Acute Cloud is built to streamline matching patient needs to the optimal post-acute care setting – driving operational efficiencies and improving patient outcomes. It enables health systems to send, track, and optimize post-acute placement processes from one platform. This allows health systems to operate as one across multiple settings of care, including acute, ambulatory, and post-acute facilities for longitudinal care coordination. It also automates placement steps, such as sending referral requests, clinical documentation transfer, secure communication with the network, and transportation coordination. These capabilities reduce the administrative burden on case managers.


Network Strength
Strong PAC network relationships improve financial and patient outcomes. Creating a high-performing network takes time and dedication but if you have the right technology partner in place, you can quickly identify the PAC providers who are best serving your health system. Once your high-performing network is in place, a consistent touch base cadence to share data and discuss any friction points will help ensure ongoing success.


For example, ABOUT curates our post-acute provider network of 60k+ facilities, meaning we source, verify, train, and maintain each facility on a regular basis to ensure accurate, up-to-date data, and fast response times.




The next step after optimizing your discharge planning and post-acute placement operations is to align with overall patient flow operations and logistics. This includes admissions and transfers into the health system, patient progression and capacity management throughout the patient journey, and care continuity post-discharge. When all teams work together using standardized processes and technology, you are effectively using resources across the health system, opening bottlenecks to create more capacity, and ultimately allowing you to drive more demand and growth.


Learn more about standardizing post-acute placement across care settings: Watch our recent PAC Coffee & Care Orchestration Webinar.