Team Leads

• Jeffrey Schnipper, MD, MPH (Brigham and Women’s Hospital)
• Ryan Greysen, MD, MHS (University of Pennsylvania School of Medicine)

Authors

• Armond Esmaili, MD (University of California, San Francisco School of Medicine)
• Ifedayo Kuye, MD, MBA (University of California, San Francisco School of Medicine)
• Rachel Weiss, MD (University of Virginia School of Medicine)
• Efren Manjarrez, MD (University of Miami School of Medicine)
• Jennifer Goldstein, MD, MSc (Elsevier Publishing, formerly ChristianaCare Health System)
• Mara Bann, MD (University of Washington School of Medicine)
• Lekshmi Santhosh, MD, MAEd (University of California, San Francisco School of Medicine)

Discharge Criteria Group Publication

Greysen RS, Auerbach AD, Mitchell MD, et al; for the HOMERuN Collaborative Working Group. Discharge practices for COVID-19 patients: rapid review of published guidance and synthesis of documents and practices at 22 US academic medical centers. J Gen Intern Med. 2021;36(6):1715-1721. DOI: 10.1007/s11606-021-06711-x

Topic Area

An important issue facing hospitals across the US is determining when it is safe to discharge COVID-19 patients; unlike other infectious conditions, the condition of patients with COVID-19 can worsen in the second week of illness after a period of initial stability. It is critical to understand who can be discharged safely to minimize length of stay and bed occupancy while also reducing post-discharge adverse outcomes such as readmission. In the absence of evidence of help to guide these decisions, HOMERuN has conducted a rapid review of discharge criteria at member hospitals by comparing and contrasting discharge practices at 22 academic medical centers.

Professional Society Guidance

• The Society of Hospital Medicine has compiled clinical guidance from a number of societies, including the Centers for Disease Control and Prevention (CDC), World Health Organization (WHO), and the Infectious Diseases Society of America (IDSA).
• To our knowledge, none of these guidelines specifically address the issue of when it is safe to discharge a patient with COVID-19 from the hospital.
• The CDC has guidance on when it is safe for a patient to be taken off quarantine, but this is not the same as when it is safe for hospital discharge.
• The Penn Medicine Center for Evidence-based Practice has summarized professional society and public health agency guidelines on discharge criteria, including discharge criteria used at select hospitals.