(1231) App-based immediate discharge vs. standard-discharge process: effects on time to departure, safety, and satisfaction

Maternal and fetal medicine units are often overwhelmed. As medical assessment is prioritized over preparing discharge letters, the resulting delay leads to patient dissatisfaction, increased costs, and staff burden. In our unit, a mobile health application (app) provides access to lab results and discharge letters, allowing immediate discharge without waiting for a printed letter.
We aimed to compare app-based immediate discharge with the standard discharge process regarding time to departure, safety, and patient satisfaction.

Study Design:

A randomized controlled trial conducted in 2025 at a university-affiliated medical center. Hospitalized pregnant women expected to be discharged before delivery were randomized to app-based or standard discharge. Randomization was based on discharge day in an alternating pattern (Sunday–Thursday), with the order reversed weekly.
The standard group received a printed discharge letter before leaving. The app group received one-page with recommendations and contact details, and were discharged home. The full discharge letter was later accessible via the app. Patients were instructed to contact the department if the letter did not appear within 24 hours.

The primary outcome was time from discharge decision to actual physical departure. A phone interview was conducted within one week to assess satisfaction, experience, and understanding.

Results:

Sixty women were included per group. Patient characteristics are shown in Table 1. Time from discharge decision to physical departure was significantly shorter in the app group (0.8±0.8 vs. 2.2±1.3 hours, p< 0.0001). Satisfaction scores were higher with app-based discharge. The recommendations of the single-page summary and full letter were consistent. All app-group patients successfully accessed their discharge letter.

Conclusion:

App-based immediate discharge significantly reduced time to departure and improved patient satisfaction without compromising safety.