Patients who present with a Pulmonary Embolism (PE) to the Emergency Department (ED) can be safely discharged home if they are relatively low risk for other complications, yet most are still admitted despite the low value of admission. MPrOVE worked with ED leadership to provide a safe discharge pathway for patients and providers. This project aims to increase the rate of low-risk discharges, expand the availability of hospital beds in the ED, and improve the patient experience.

Background: There have been numerous studies, trials, meta-analyses, and guidelines demonstrating the safe outpatient management of low-risk pulmonary embolisms (PE). Per this literature, 20-50% of acute PE patients are candidates for discharge. However, only about 2% of Michigan Medicine PE patients are discharged from the ED. An internal case review and risk assessment of all PE patients in the ED revealed that at least 21% of these patients are very good candidates for discharge to home.

MPrOVE Insights: MPrOVE, in collaboration with ED Clinical leaders, developed a comprehensive safe discharge pathway that includes:

• An automatic risk score calculation in the Electronic Health Record (EHR)

• Comprehensive order set for discharging home

• Steps to ensure patient has access to medications & follow-up appointments

• Specific documentation and patient instructions

Anticipated Outcomes: Once fully implemented, this low-risk PE discharge model aims to:

• Increase rate of low-risk PE discharges

• Expanded access by reducing unnecessary use of hospital beds

• Improved patient experience for earlier discharge home

Additional Links:

Low Risk PE Discharge Website