A daily scrum at the gastrointestinal oncology ward shortens the length of stay, a tertiary center experience

Background and aims: Multidisciplinary meetings among medical and paramedical staff can limit the length of stay (LOS) of oncology patients during repeated hospitalizations. We applied the scrum methodology to streamline our discharge planning. This framework originated in IT development to address operational challenges and to allow for rapid adaptation. We aimed to assess whether a daily scrum can impact LOS and the readmission rate.

Methods: We implemented a daily multidisciplinary meeting, called scrum at the 26 bed- Gastro-intestinal (GI) oncology ward of our tertiary center from October 2022 to July 2023. This daily multidisciplinary debriefing determines the exact medical and paramedical criteria for discharge. We compared outcomes during the intervention to a four-year pre-intervention baseline. We applied a linear model to evaluate whether the scrum reduced the LOS while correcting for case mix.

Results: We included a total of 664 GI oncology patients over a 10-month period. The adjusted mean LOS was 4.09 days. After correcting for case mix, LOS decreased significantly during the daily scrum period compared to the four-year pre-scrum baseline (-9.96%, p=0.011). Unplanned readmissions within 30 days from discharge did not increase.

Conclusion: Implementing a daily scrum significantly reduced the length of stay at our oncology ward. The scrum framework provides an effective strategy to optimize bed capacity. It minimizes unnecessary hospital days and reduces the risk of suboptimal patient care.

Keywords: length of stay, patient readmission, interdisciplinary communication, patient discharge, quality improvement, oncology.