The early discharge clinic: A safe and efficient model for intensive outpatient management of hematologic malignancies

Abstract

Abstract Hematologic malignancies often necessitate complex treatment regimens that can result in prolonged hospitalizations, increasing healthcare costs, and straining resources while diminishing patients' quality of life. To address these challenges, Northwell Health established New York State's first Early Discharge Clinic (EDC), designed to facilitate a safe and efficient transition from inpatient to outpatient care. We describe nine pillars (Clinic Hours and Access, Scheduling, Laboratory Services, Infusion support, Urgent Radiology, Procedures, Pharmacy Services, Hospital Readmission Protocol, and Support Services) that actuated the operationalization of the program, report early outcomes, and compare length of stay to historic matched controls. During 2023 and 2024, 112 unique hematologic malignancy patients enrolled 191 times. Patients had a median of five evaluations, nearly all received blood products, and when required, time to first antimicrobials was <48 minutes. Eleven non-scheduled re-admissions occurred during the first week post discharge for 191 enrollments. Compared to historic controls, the average length of stay decreased by 10.2 days. The program demonstrated a safe and effective model for outpatient management of patients undergoing intensive therapy for hematologic malignancies. These findings offer valuable insights into the potential of EDCs to enhance care delivery while optimizing resource utilization.